'LIBRARY OF CONGRESS. 



-S& in I t 



t UNITED STATES OP AMERICA. t 




THE 

DOCTEINE OF PURGATION. 



€mhttxtksfxam %mxmt uvfo Utokm ITitatet 



A COLLECTION OF QUOTATIONS ON THE USE OF PURGATIVES, 



FROM 



HIPPOCRATES, 

AND OTHER MEDICAL WRITERS, 

COVERING A PERIOD OF OVER TWO THOUSAND YEARS, 

PROVING 

JJargation 10 % €orner-0tone of all duratisea. 



COMPILED BY B. 'BRANDRETH, M. D., SING SING, N. T. 
SECOND EDITION. 



NEW YORK: 
BAKER & GODWIN, PRINTERS, 

PRINTING-HOUSE SQUARE. 

1871. 



^ 






* 



«\\ 



Entered, according to Act of Congress, in the year 1871, by 

BENJAMIN BRANDRETH, M. D., 

In the Office of the Librarian of Congress, at "Washington. 



v. 



INTRODUCTION TO AUTHORITIES 

FOE 

DOCTKINE OF PURGATION, 



ABB 



OPINION AS TO CAUSE OF DISEASE AND PREMATURE DEATH. 



Life may be considered the union of soul and body. It is one of the most impene- 
trable secrets of Him who lives in all things, and in whom all live, and move, and 
have their being ; who, in His goodness, has led man, as by the hand, to the path 
whereby he may arrive at a knowledge of his bodily infirmities and death ; and how he 
may reduce the one, and thereby keep the other at bay. All nature is God's work, but 
man is the only living creature that appears to be endowed with cumulative reason. 
The Bible tells us he is fallen from his primitive condition of happiness, and in con- 
sequence of this fall, he receives at his birth a germ or principle of corruptibility, 
which continues to be propagated throughout all time. For the child receives from 
his parents the principle of his life, and also that of his death — corruption. From 
long study and experience, we are convinced that ihe death principle is corruption, 
or therein contained. The examination of the dead proves this ; the putrefaction 
we observe tells us plainly that if that had been removed in time, life would not 
have been extinguished. The principles of life and death occupy the same body, 
and one or the other must rule. In order, therefore, that we continue in health, the 
principle of life must have the balance in its favor. Our method teaches this impor- 
tant knowledge. Some writers fix old age at between fifty and sixty years. Every 
five years that a man lives after this period may be set down as a degree added to 
old age. If there are so few who reach an advanced period of life, it is because the 
innate principle of corruption becomes active, and disease breaks out with more or 
less malignity, and the proper means not being employed, death may follow, the 
individual not having reached that age he should and ought to have attained from 
the principle of life which he possessed. We look upon this as premature, not nat- 
ural death. Natural death is a cessation of all the faculties ; the man or woman 
falls asleep, ceasing to exist without effort or struggle. 

It is true that all men must die, but no one need die of disease. Even now, hu- 
man beings have a longer average of life than was their lot in the last century. This 
may be the consequence of a better knowledge of the laws of life. Let it be com- 
prehended that we carry within ourselves the cause of disease and death ; let us 
admit this fact, and not wait until convinced by the terrible manifestations of pain 
and inflammation. 

To apply the remedy in time is the knowledge needed. It is worthy of remark, 
and we see with surprise, that young persons, apparently in the full vigor of health, 
whose complexions seem to indicate the most robust constitution, are oftener attacked 
by severe disease than persons always pale and feeble. These persons have more 
vitality, which occasions a quicker waste or change in the material of their bodies, 
so that when they are sick, unless the secretions are restored immediately, the death 
principle gaixs the ascendency. Prompt measures in the right direction are all that 
is needed, and in such cases purgation means life, and the want of it means death. 



4 THE DOCTRINE OF PURGATION. 

Some persons are peculiarly blessed with health '. In their constitutions no im- 
purity shows itself, often taking one hundred years or more to wear out the " spark 
of life." In others, life has ceased before birth, and the child is still-born. 

All the solid parts of our bodies are made from fluid ; first derived from the 
blood of the mother, then from the mother's milk. Thus solids and fluids constitute 
our material being. 

WASTE AND REPAIR. 

The body wears. Movement causes waste. The hardest steel wears away when 
used. So also the body wears away, but, unlike the steel, it is renewed faster than it 
wears away in a child, which is the occasion of its growth. It is a great truth, we 
die daily ; but the food consumed also supplies us with new life daily. These are 
marvelous facts ; this decay and renewal are among the wonderful mysteries of the 
Almighty. 

We know the hair and nails grow. Mark your finger nail near the root. 
Day by day it advances toward the end ; at length we pare the mark away. The 
whole nail has been renewed, the growth was supplied, the waste was repaired. 
The same waste, the same renewal occurs in the nose, and all other parts, though we 
cannot mark the change as in the finger nail. 

WHERE THE REPARATIVES ARE. 

The substance which is to form the nail is in the blood ; as perfectly mixed as a 
grain of salt is dissolved in a glass of water. As the blood circulates in the small 
vessels at the root of the nail, this nail substance deposits and organizes itself, and 
replaces what is worn away. The hair is also renewed by materials from the blood 
deposited in the roots of the hair ; so the bones ; and so the flesh ; and so with all 
other tissues and parts of man's body. Each part receives its needed supply of new 
material. Thus the eye retains its fire, the tongue its power of utterance, the 
brain the power of thought. 

Analogy tells us even the brain, the organ of thought, wears, and is renewed by 
the blood, which circulates and renews all the parts of the body alike, whether it be 
brain, spinal cord, the eye, the bones, the flesh, the hair, or the nail. 

The blood carries new material to repair the waste, and it reloads itself with 
worn-out parts which it discharges through the appropriate vents. When the new 
materials are greater than the waste, the child grows ; or the man spreads. When 
the waste is exactly equal to the new material, the body remains of the same size 
and weight. These facts indicate that all substance of all the organs and parts of a 
living body are present in the blood. It is therefore important to our well-being 
that this life fluid should be free from imperfections. 

For if the blood does not contain all the needed ingredients, or if it should 
contain more, it cannot renew the different parts according to their requirements. 
Deformed and ill-made people owe their infirmities to the blood of their parents ; 
pure blood cannot do otherwise than make perfectly organized beings, thus we may 
estimate the value of certain means to make the blood perfect. 

Food, by its organ the stomach, supplies all the parts of which blood is made. 
We now speak of this conversion. 

DEFINITION. 

SUBSTANCES WHICH CONTAIN AND SUPPLY NUTBITION ARE POOD. 

Healthy food possesses substance, because the stomach cannot grind it well with- 
out it possesses this quality. Too fine food makes the stomach weak ; it cannot 



INTRODUCTION. 5 

use its muscular power, and debility of the stomach follows. If we do not walk, our 
legs soon become weak. To be strong, organs need exercise. When food is digested, 
part makes blood ; the refuse passes off by the bowels, the kidneys, and the skin. 
Our stomach, if properly supplied, continually prepares new blood, which renews all 
the organs, carrying vitality to the hair and nail as well as to the head, with its 
master-organ the brain. Every part is each moment of our lives changing, the worn- 
out parts earned away, and new parts supplied, whether good or bad. Here we see 
the necessity of eating and drinking several times a day. We constantly wear and 
constantly repair. Such is the law of our being. 

WORN-OUT PARTS MUST BE EXPELLED. 

The worn-out parts must be expelled from the body daily, or the blood will be- 
come impure. We may comprehend this by an inquiry respecting new-born chil- 
dren. They have taken no food by the mouth, and yet when born their bowels and 
bladders are full. Whence did these secretions come ? They came evidently from 
the blood of the mother, which made their bodies. We also know that sick persons, 
who eat no food for days, have evacuations by the kidneys and bowels. These parts 
are also the worn-out parts of the blood. 

The blood is, in fact, a messenger which takes to every part of the body what it 
needs for renewal, and also carries back to the bowels, kidneys, and skin, worn-out 
substance to be expelled from the body. 

We therefore must admit that every part of a human body is made from blood; 
and that it wastes and is repaired ; that food makes blood, which is distributed with 
singular intelligence to all the various organs. 

HOW IMPURE BLOOD IS DEVELOPED. 

The bowels may be costive ; in this case there is an absorption into the circulation, 
of gases and gummy substances, which are a great cause of poison to the blood. 
Should the kidneys fail to do their work, another source of poison to the blood is 
developed. Again, should the perspiration be checked, matters flow back upon the 
blood which soon load it with impurities. Suppose only the feet, by cold, cannot 
perspire, and their fetid exhalations j^)wback upon the blood. If all these outlets 
— the skin, the kidneys, and the bowels — do their work even imperfectly only, for a 
short time, it is evident that the blood will be burdened with noxious matters, which 
must interfere seriously with the circulation, and soon clog up the smaller vessels, so 
that only a small amount of blood can pass. Soon the lungs, the intestines, the 
stomach, and the brain will sound an alarm. You will have pleurisy, inflammation 
of the bowels or severe cholic, violent headache, or sick stomach. Because the 
worn-out parts of the body, instead of being carried out by those avenues nature 
designed, are shut up, poisoning the blood, thus causing it to become impure. 

Other causes besides these produce impurity of blood. The food may not be 
healthy ; digestion may be imperfect; troubles, grief, anxiety, miasmas from swamps 
or other exhalations; breathing close air in crowded rooms; staying in too hot 
rooms; all these causes tend more or less to vitiate the blood. Grief, fear, and 
anxiety, hurt, by making the Hood to circulate slower, and soon produce a very serious 
injury to the composition of the blood, occasioning stubborn fevers, and various 
derangements of the body and mind. 

The best part of food makes chyle, which is absorbed into the circulation, to 
repair the waste the blood sustains in rebuilding the body, and in forming bile and 



6 THE DOCTRINE OF PURGATION. 

all the other fluids of the body — for all the fluids are made from the blood. The 
coarse portions, and those not needed, are expelled daily by the bowels, the kidneys, 
and the skin. 

The fluids, or as some writers call them, the humors, are as natural and necessary 
as the blood. It is not from humors we are sick, but from the humors becoming 
unsound ; from infection, or absorption of fungi, or other poisonous vapors or matters. 
These produce a putrid fermentation, or chills and fever, or fevers continued or in- 
termittent. 

It is supposed that in the humors resides the germ of corruptibility, which is 
aroused into activity by the above causes. 

To have humors is as natural as to have blood. It is not having humors that causes 
us to be sick, but because they become corrupted. . The humors absorb infection, in 
consequence of their being the seat of the innate germ of corruption. When this 
germ or root, from any cause, receives an increase, it may show itself by colds, ca- 
tarrhs, tumors, or other effects, by which life may be shortened, or a serious attack 
of some specific disease produced. 

Corrupted humors always cause sickness ; they cause death. If they are removed 
in time, the sickness is cured, and death prevented. We know they can be removed, 
and should not corruption be quickly removed from a living body ? Their infec- 
tious smell tells of their hurtful nature to a living body; cleanse, sweep out from the 
bowels and blood the unhealthy parts, and your disease will soon be cured. 

While in health, the humors and the blood are sound ; but so soon as you do not 
feel well, be sure the humors and blood are getting deranged in their sound quali- 
ties ; and when painful sensations are felt, we should at once take steps to prevent 
serious trouble. These steps usually are evacuation, for we cannot recover health 
until the blood and the humors are freed from all acrid and unhealthy qualities, 
however acquired. 

The humors, after becoming corrupted, soon accumulate a degree of acrimony or 
burning heat, that the burning sensation is often almost insupportable. They often 
resist great quantities of purgatives, but outward applications are really useless 
without evacuation of the bowels. 

Two hundred medical writers, running through a period of over two thousand 
years, agree as to the means of reducing this ^eath principle — agree as to a general 
indication — agree as to the perfect innocence of purgation. We hold that this 
evidence is important in our intelligent age, and hope it may lead to a more uniform 
and a more humane method of treating patients. Perhaps a wise regard for the im- 
provement of the human race will make purgation the principal curative reliance ; 
other means should be only secondary. Physicians may soon be governed by this 
rule, because purgation may be set down as the magnet, the guide, the star of safety. 

Purgation corrects errors in the digestive organs ; and Dr. Abernethy observes 
(in Surgical Observations, p. 22): "By correcting the obvious errors in the state of 
the digestive organs, local diseases which had baffled all attempts at cure by local 
means, have speedily been removed." When local applications are applied, they 
should be in harmony with purgation, and incapable of doing injury. 

We can remove disease in two ways : ' by the upper and by the lower passages — 
by vomiting and by purging — purging when the patient is weak, vomiting only 
when he is strong. We will define purgation as " cleansing," and apply to both the 
upper or lower ways. 



INTRODUCTION. 



For forty years I have directed my attention to the cure of disease on this plan, 
and facts derived from experience have long since confirmed me in the belief that 
this is calm Nature's own method of cure, because it assists her in removing impuri- 
ties by the means and outlets she has so wisely provided for herself. 

Believing that all mineral and chemical agents which can act on foreign or im- 
pure matters in the blood, invariably injure the organization of the blood itself— 
destroying its corpuscles, besides injuring the coats of the stomach, and producing 
serious effects upon the bones — I have therefore discarded minerals and chemicals 
entirely, and trust to vegetable remedies alone. 

That which I have principally employed to enforce this theory has been Brand- 
reth's Pills, whose permanent and wide-spread success is the strongest evidence of 
their distinguished merit. 

The question has been asked, If the value of this medicine is so great, is it not a 
duty to make known its true components, so that physicians and others could pre- 
pare it ? To this it may be answered, that if Brandreth's Pills certainly would be 
made the same as they are now, and all their healing, cleansing and innocent quali- 
ties retained, one of the reasons for their remaining a secret medicine would be 
removed. 

But every man knows, who knows anything of the drug and medicine business, 
that not one box in a hundred would be prepared of such medicines as are incorpo- 
rated in the Brandreth Pills prepared by me. It is true the pills might be composed 
of ingredients called 1y the same name, but the name would be all the resemblance 
they would possess to the pure extracts and medicinal preparations which comprise 
the composition of Brandreth's Pills. 

Therefore, for the sake of the lives and health of men — for the sake of the 



GREAT SANATORY THEORY OF PURGA'IION — 

the manner of preparing Brandreth's Pills will never be divulged, until the time 
arrives when all the drugs of the stores shall be true and uniform preparations. 

I am not without examples for this decision : 

Dr. James, the celebrated author of James' Powder, left his prescription to Messrs. 
Newbery & Sons, of London, more than a hundred years ago, by whom they are yet 
made. The great Stahl and Hoffman, of Germany, Professors of Physic at Halle, 
without scruple confined many medicines to their own private practice. And even 
in our own time, there are few medical men of extensive practice who have not rem- 
edies which they carefully retain in their own families, who are more likely to prepare 
them with reference to securing their curative effects, without regard to profit, than 
they would be in the hands of strangers. 

The quotations from the writings of medical men, embodied in this pamphlet, 
prove the talent that has been at work upon this Theory of Purgation for over a 
period of two thousand years— and in vain. Then what has prevented its complete 
success ? Simply this, in my opinion : Not a single writer has given a medicine 
which, out of their own hands, would successfully and safely enforce the purgative 
theory. 

The public, in Brandreth's Pills, have a medicine which it is intended shall ever 
be within its reach, always certain to purge only impurities from the blood, and 
when the upper ways require cleansing, occasion vomiting ; and that is safe for both 



8 THE DOCTRINE OF PURGATION. 

sexes and all ages. Composed of vegetable preparations entirely — indeed, the Pills 
are guaranteed to contain no mineral in any form — they may, if the requirement of 
the constitution need them, he taken daily for any length of time, without a possi- 
bility of producing any bad effects, on the body, and must reduce the sum of disease. 



WABEANTEE. 

That Brandreth's Pills, in all future time, are warranted to 
possess and contain those purgative, those cleansing and innocent 
qualities, which they have always heretofore possessed in so 
eminent a degree. 

The principle of curing disease by the use of purgatives is beginning to be exten- 
sively recognized as indispensably necessary for the recovery of health by many 
intelligent families and individuals. To prove to them and to the world at large, as 
well as to physicians of all schools, the broad and deep foundations and authority 
this principle of cure possesses, I have printed the following extracts which, as in a 
mirror, is exhibited the views, and experience, and sentiments of medical men, dur- 
ing a period of over two thousand yeaes. 

They possess a peculiar significance for those who desire to investigate this sub- 
ject, so important to the lives and health of men, because they throw a flood of light 
on the application of purgatives as a means of removing disease from the system. 

The great aim by many of these writers is, that in the administration of medicine, 
we should do good possibly, but never harm. 

Bleeding, Mercury, Tartar Emetic, Antimony, Veratria, Strychnine, Morphine, 
and a host of similar remedial agents may, nay generally do, a great deal of harm, 
and often are the occasion of fatal mistakes ; while the great advantage of using 
Brandreth's Pills in sickness is, that they never make any mistakes, often prolonging, 
never shortening life. 

In pleurisy, in inflammation, in fevers, and where pain is present, their prompt 
and energetic administration is often life-saving, and it is in evidence they have 
often effected cures when physicians and friends had given up all hope. Then what 
risk does any man or woman incur in using a medicine like Brandreth's Pills, which 
are the adopted remedy of millions of families living in every part of the civilized 
world ? 

The facts given in the following pages prove that fevers, inflammations, and 
severe pain are only, in reality, so many evidences of healthful constitutional power, 
and that if purgation is enforced according to the necessities of the case, the fever, 
severe pain, or inflammation will be removed, provided no sedatives or narcotics 
are employed. 

B. BRANDRETH. 
Sing Sing, June 1, 1871. 



HlPPOCKATES. 



Purgation the Corner-stone of Curatives. 



Hippocrates. — Aphorisms, written about 400 b. c. Edited by Elias 
Maries, M. Z>., New York, 1818. 

1. Life is short, art long, occasion brief, experience fallacious, The golden 
judgment difficult. It is requisite that the physician exhibit what is 
essential, and that the patient, attendants, and all which surrounds .him, 
concur therein (1, sect. I). 

2. In diarrhea and spontaneous vomiting, if the matter voided be of n Diarrhea. 
a nature that ought to be expelled, let the patient be purged, for in this 
case the evacuations are beneficial and are easily supported (2. sect. I). 



rurpation in- 
dicated by 



The power 

3. The greater the evil the more vigorous the remedy (6, sect. I). ° f the reme * 

4. In acute diseases the most violent symptoms supervene ; the on Diet, 
severest regimen is, therefore, to be observed. But if these symptoms 

be wanting, a more generous diet is to be permitted, only we are to 

have recourse to it in proportion to the subsidence of the malady (7, 

sect. I). In the choice of regimen, more evil results from abstraction _ The nutri- 

than from a small excess. A thin, frugal, and over-exact regimen cure. plan ° f 

accords not even with the man in health, who grievously supports the 

privation. Hence, in general, the superiority of a due refection over 

that which is deficient {5, sect. I). 

5. In those diseases which quickly arrive at their climax, a thin Diefc t0 be 
regimen should immediately be adopted. In those which attain it at a regulated ao- 

-it • i i i J a. i J* i -it » cording to 

somewhat later period, we should at or before that period, subtract from the charac- 
their diet \ m but, until then, sufficient nourishment should be allowed, disease. te 
that the strength of the patient may be supported (10, sect. I). 



G. That which is excrementitious should be drawn off at the point 
to which it most tends, by the most convenient outlets (21, sect. I). Diurei 

* ' SudoriGca. 



Purgatives, 



10 THE DOCTRINE OF PURGATION. 

when to 7. Purgatives should be administered after the food on the stomach 
gire g purga- ig concocte( } ? no t w hil e it i s yet crude (22, sect. I). 

Note by the Editor. — There is no danger in administering a purgative before or after a 
meal, provided there be pain or dizziness, which symptoms are relieved by purgation . 

8. Depletion is not to be estimated by its copiousness but by its 
how to di- being judiciously used and easily supported. When it is necessary to 

rect the pur- extend it " ad deliquium animi," let it be done, but previously consult 
emg * the resources of the patient (23, sect. I). 

Note by Editor. — Where there is danger of congestion, purgation may be enforced to 
fainting with Brandreth's Pills (see paragraph 55). 

9. If the convalescent acquire not strength from the food he takes, 
it shows that the body needs a more plentiful supply. But if the same 
eifect arise from an inability to partake of food, it sufficiently evinces 
the necessity of purgatives (8, sect. II). 

10. When it becomes necessary to purge, the evacuations ought to 

ev2cSn.° f be l00Se and free ( 9 > Sect - I][ )- 

11. Impure constitutions, when most nourished, are most injured 

rect the nou- (10> SQCt. H> 

rishment. 

Relapses 12- The (morbid) matter remaining in the body after the crisis is 

SeS in m m &- P as ^ °ft en produces a relapse (12, sect. II). 

tion. 

Chan e of ^« ^ n a l yme fluxes, a change in the dejections, unless they assume 
dejections, a vicious appearance, is beneficial (14, sect. II). 

Tubercles. 14. When the fauces are affected, and tubercles arise therein, we 

J?8too£ tion ought to examine the excretions ; when they are of a bilious nature, the 
entire body is affected ; but if they be as in health, we may safely 
impart nourishment (15, sect. II). 

Disease 15. Excess of food produces disease, and at the same time points out 

pe^nce ter in "the remedy (17, sect. II). The sickness which arises from repletion is 

dink- pur- CUTe & by evacuation ; and that which arises from evaluation, by reple- 

gation' the tion. Thus, opposites are counteractives of each other (22, sect. II). 

16. Evacuation, repletion, frigeration, and calefaction — these, or 
sudden ac- any other correspondent modifications of body, when excessive, or too 
nXre ga pro- suddenly accommplished, are dangerous — nature being ever opposed to 
must dinsS be ex t remes - That which is gradually done is safely done, whether we 
gradual pass from one extreme to another, or otherwise (51, sect. II). E very- 
Sad. c ° n m ~ thing which is judicious being done, without success, we are not, there- 
fore, to recede from our plan, while we still entertain the same views as 
we did at first (52, ibid). 



THE DOCTRINE OF PURGATION. 11 

17. Some diseases accord tetter with some constitutions than others ; Prcdispo- 
and this also obtains with certain ages, as connected with season, climate SnstTtutionf 
and aliment (3, sect. III). In the various seasons, if cold and heat fre- 8& a J2/23l 
quentlv alternate with each other, we must look forward to autumnal fo ° d ; c ^ an s 9 

1 . t - ' of tempera- 

diseases (I, ibid). ture. 

18. Those suffering from phthisis should avoid vomits (8, sect. IV). em^tiS* inju- 

rious. 

19. The melancholic should be copiously evacuated downwards ; and, Purgatives 
from the same principle of reasoning, those of a contrary temperament wbere^toTe 
should be differently treated (9 sect. IV). used - 

20. Sound Doctrine. — In very acute affection, attended with turg- acuujlu 
escence, purgatives are immediately to be used ; to procrastinate here 
is dangerous (10,* sect. IV). 



cases, purge 
without de- 
lay. 



21. Those who are tormented with severe gripings, pains about Griping^ 
the umbilicus, and in the region of the loins, and who are neither purgatives 
relieved bv purgatives, or anv other means, usually fall into tympanites 
(11, sect. IV). 



useful. 



22. If there be pain immediately above or below the diaphragm, 
the former demands vomiting, the latter purging (18, sect. IV). ft£J£ and 



Internal 
pains— vom- 



in 

the abdomen 
purgation 



23. Those who, during the operation of purgatives, have no thirst, Degree 
ought to be purged until thirst be induced (19, sect. IV). purging. 

24. Pain in the lower region of the abolomen, with griping and ach- p a %n 
ing of the knees, unattended with fever, indicate the necessity of pur- 
gatives (20, sect. IV). 

25. Dark-colored dejections, resembling black blood, coming on Evacua- 
spontaneously, either with or without fever, are very unfavorable ; and 
the more so if the color of these dejections become, with their continu- 
ance, still more depraved ; but if the evacuations assume a more healthy 
complexion, or, if their dark color be the effect of purgatives, less evil is 
to be apprehended (21, sect. IV). 



tions criti- 
cal. 



26. The expectoration of blood, how small soever in quantity, is Evacuation 
injurious ; but the evacuatio 
advantageous (25, sect. IV). 



injurious; but the evacuation of black blood downwards is (frequently) eJeSncha- 



27. "With, those who are deaf, a coming on of bilious evacuations Deafness,. 
generally removes it (28, sect. IV). evacuations 

28. If, in those recovering from indisposition, there occur any local Pain symp . 
pain, it foreshows the formation of an abscess (32, sect. IV). tom of ab- 

■*■ 7 . \ 7 j ecesses. 

29. From whatsoever part of the body sweat breaks forth, it fore- sweats and 
shows a determination of the disease to that part (38, sect. IV). h6at > B y m P* 



12 THE DOCTRINE OF PURGATION. 

tomatic of In whatever part of the body heat or cold arises there the disease 

cate^hene- seats itself (39, ibid). 

Where there occur alternate changes of cold and heat, and the com- 
plexion undergoes various changes of color, we may predict extended 
illness (40, ibid). 

Profuse sweats, during sleep, without any manifest local affection, 
may arise from a too plentiful diet ; but if they take place notwith- 
standing the observance of a frugal regimen, it shows the necessity of 
evacuation (41, ibid). 



cessity of 
Purgation, 



30. In fever, where abscesses have not been dispersed during the 
be purged primary stages of the disease, they 'foreshow extended illness (51 
away - sect. IT). 

Fwer, in- 31. "When, with existing fever, a thick, gummy, scant urine is fol- 
tne a uriSe. y lowed by a thin and copious discharge, it is beneficial ; but it is the 
more so, when, at the commencement of disease, or a little time after, 
the urine deposits a sediment (69, sect. IY). 

pr?gnfncy in 32. "With pregnant women, venesection ^produces abortion, especially 
causes abor- «f g es t a tion be far advanced (31, sect. Y). 

Brandreth's Pills are safe at every period of gestation with the generality of females. 
Irregular , * , , 

memtrua- 33. Discolored and irregular menses indicate the necessity of purga- 

Uon requires ,. , nn , T7 - x ° tf x o 

purgation. tlVeS (36, Sect. V). 

beScki S 'or 34. Tumors which have a soft feel are beneficial ; those which are 
malignant, hard and callous are unfavorable (67, sec. Y). 

^IT^ 35. In dropsy, if the water pass off into the intestines, by means of 

purgation , . - -S.* 7 ' /H . l ^ T ^, ' J 

the cure. tne veins, the disease ceases (14 sec. VI). 

Purgation brings it* to the intestines and so causes the water to be evacuated. 

the Eyes 36. Diarrhea supervening in ophthalmia is beneficial (17, sect. YI). 

Pupation. Pains of the eyes are relieved by pure urine, bathing, fomentation, 

venesection, and purging (31, sect. YI). 

Fever the 37. Pains in the hypochondrium, unattended with inflammation, are 

naturalcure. re l ieved by f ever ^ gect yi). 



Effects of 38. Long-continued dysentery, supervening in affections of the spleen, 

glected 
purgation. 



induces either dropsy or lientery, and consequent death (43, sect. YI). 



Purging in 39. Those with whom purgatives agree should have recourse to 



Spring. fa^ ^ ^ s ^p r i n g (^ g ect . YI). 



wheninfiam- 40. Those attacked with the gout are entirely freed of it in forty 
purg°daway. days after the subsidence of the inflammation (49, sect. YI). 

More effects 41. In atrabilious affections the translation of the humors to various 
pul-gauott* parts has a tendency to produce the following diseases : apoplexy, 
onania, convulsion and blindness (56, sect. YI). 



THE DOCTRINE OF PURGATION. 



13 



42. "WTien a serous collection, attended with pain, takes place be- Accm/mia- 

tween the abdomen and diaphragm, without its having an issue in either inXSs r^ 

cavity, if the fluid be drawn out of the body bj means of the veins, the Ton Qpu ' aa ~ 
disorder ceases (54, sect. VII ; vide Aph. 14, sect. YI). 



43. Excessive perspiration, cold or hot, continually going on, is in- 
dicative of redundant moisture within ; we ought, therefore, to evacuate 
it from the system either by vomiting, if the patient be strong, or by 
purgation if he be weak (61, sect. VII). 



Sweat — in- 
dicative of 
fluid accu- 
mulations. 
Cure, Pur- 
gatives. 



44. He should attend to the urinary discharge in order to ascertain 
whether it be conformable to what takes place in health ; in proportion 
as it departs from the healthy state is the severity of the disease, and 
" vice versa " (66, sect. VII). 

If, on suffering the urine to remain, without disturbing it, we ob- 
serve a deposit resembling sawdust, the greater or less quantity of this 
deposit is indicative of the severity or mildness of the disease ; in either 
case, it is necessary to have recourse to purgatives • in proportion as we 
neglect these, for a nutritive regimen, will be the augmentation of the 
disease (67, sect. VII). 



The urine 
a criterion of 
health or dis- 
ease — its tur- 
bid condition 
indicative of 
Purgation. 



45. In continued fever, the expectoration of a livid, bloody, bilious, Continued 

or foetid' matter, is alike unfavorable ; but, if the expectoration be good, rTn^nduri- 

and in due season, it is favorable. The same may be said of the alvine ^omlaZ 

and urinary discharges ; furthermore, any excrementitious matter re- and \P wr ' 

maining in the system, and not coming away with the evacuations, quired! re 
proves injurious (69, sect. VII ; vide Aph. 12, sect. II). 



Hippocrates, the genuine works of. Transl. by Francis Adams, ZL.D., 
and printed for the /Sydenham /Society. 2 vols. London, 1849. 

46. Medicine is, of all arts, the most noble ; but, owin^ to the is:no- 



Medical 



ranee of those who practice it, and of those who inconsiderately form a 1 s aor&nce - 
judgment of them, it is at present far behind all the other arts (The 
Law, p. 784, vol. I). 



47. When nature opposes, everything else is in vain. 
physician of diseases (p. 102, vol. I). 



Nature is the Nature - 



48. The physician must have his special object in view with regard 
to diseases, namely : to do good or to do no harm. The art consists in 
three things : the disease, the patient, and the physician. 

Ttte physician is the- servant of nature, and the patient must combat 
the disease along with the physician (Epidemics, Book 1, § 5, p. 360, 
vol. II). 



The phy- 
sieiari's spe- 
cial object. 



The ser- 
vant of na- 
ture. 



49. Gentle purging of the bowels agrees with most ulcers, and in uicers. 
wounds of the head, belly, or joints, where there is danger of gangrene, tiy. rge gcn * 
in such as require sutures, in phagediac, spreading, and in otherwise 
inveterate ulcers (On Ulcers, pp. 796-7, vol. II). 



14 THE DOCTRINE OF PURGATION. 

Purge in 50. Disorders arising from repletion are removed by evacuation (On 



plethoric 



the Nature of Man, p.' 262, vol. I ; Aplior, 22, sect. II) 

Fevers pass 51. When the discharges become thicker, more concocted, and are 
the y onorMd freed from all acrimony, then the fevers pass away, and the other symp- 
toms which annoyed the patient (Ancient Medicine, p. 174, vol. I). 



matter is re 
moved. 



Mnnypain 



52. When there is an overflow of the bitter principle, which we call 
fui^symp- yellow bile, what anxiety, burning heat, and loss of strength prevail ! 
ntoved by ^ u ^ ^ relieved from it, either by being purged spontaneously, or by 
artificial or means °f medicine seasonably administered^ the patient is decidedly re- 
purgation, lieved of the pain and heat. But while these things float on the stomach 
cure? nytrue unconcocted and undigested, no contrivance could make the pains and 
fever cease ; and where there are acidities of an acrid and eruginous 
character, what varieties of frenzy, gnawing pains in the bowels and 
chest, and inquietude prevail ! And these do not cease until the acid- 
ities be purged away (p. 174, vol. I, ibid.) 



The bad 53. The coction, change, attenuation, and thickening into the form 
m iSriou8 ° of humors, take place through many and various forms (p. 174, ibid.) 



m , 54. We must purge and move such humors as are unconcocted (p. 

What to Hr . n , TT . r fe> vr 

purge. 703, VOL 11). 



Purge until 
evacuations 



55. The evacuations are not to be judged of by their quantity, but 

whether they be such as they should be, and how they are borne. And 

even tof aha- when proper to carry the evacuation to " liquidium animi " (faintness), 

ms * this, also, should be done, provided the patient can support it (p. 704, 

vol. I ; Aph. 23, sect. I). 

Note by Editor. — To give the patient an opportunity of doing so, have gruel or light 
broth ready for him to sip a little at a time. Intelligent nursing must go alongside of the 
purgative method, then success is moderately certain. 

purgative 56. If the matters which are purged be such as should be purged, 
axiom. the evacuation is beneficial (p. 704, vol. II ; Aph. 2, sect. I). 



'ects of 57. Bodies not properly cleansed, the more you nourish, the more 

ton y°u in J nre (p- ^ 06 5 v °i- u ; Aph- 10 5 sect - H)- 

What remains in diseases, after the crises is past, is apt to produce 
relapses (p. 707, vol. II ; Aph. 12, sect. II). 



insuffic 
purgation, 



Purgative 58. In purging we should bring away such matters from the body 
as it would be advantageous had they come away spontaneously (p. 723, 
vol. II). 



axiom. 



■ov. wwr Doctrine. — In very acute disease, purge on the first day, for 
bad thing to procrastinate in such cases (p. 724, vol. II ; 



59. Our 
easesTpurge it is a very bad thing to procrastinate 
Aph. 10, sect, IY) 



only. 



THE DOCTRINE OF PURGATION. 15 

60. In convalescents from diseases, if any parts be pained, there are Deposits 
deposits being formed. But if any part be in a painful state previous jjjy SgJ£ 
to the illness, there the disease fixes (p. 728, vol. II ; Aph. 32, sect. IY). tion > 

61. N\ B. — The translator says : " Hippocrates was strictly the phy- Experience 
sician of experience and common sense." am common 

x sense. 

62. Nature finds out ways for herself without consultation ; nature, Nature's 
untaught and without learning, does what is needful (Epidem., lib. VI, 
S. 5, fidinb. ed.) 



ways to 



63. Asclepiades, about 100 years B. C, the earliest hydropathist, con- simpieam 
trived easy methods, and such ones as any one might use without the JgJ ^ml a ' 
help (and cost) of a physician. This made them very acceptable, and <k«i the 
Plinius (Lib. XX YI, Cap. Ill, p. 444) writes about him the follow- S'tSpS^ 
ing : " Five things of most common benefit he held to : Occasional ab- wtth^wJLte- 
stinence from meat, at other times from wine, the use of the flesh-brush, *2JJj/2f*» 
the exercise of walking and of riding ; which, as every one believed he oieanUness, 
could prescribe for himself such remedies as these, and as it is natural ^mZeTclte 
to wish those things true that are most easy, made all people flock unto %^rve udy 
him as to one sent from heaven." He disapproved of the then popular health and 
practice of frequently using violent emetics and purgatives, for which he ease. 
substituted the clyster as the safest way to obtain — what appeared to 
him the first measure to be taken in most of diseases — evacuation of the 
botvels. His method of employing simple remedies, for the sake of their 
safety and innocence, but producing the effect wished for, and his extra- 
ordinary skill in a quick diagnostic, gained him a fame that almost 
overthrew the old heroic method of the then practitioners of Rome, as 
we read of him in Plinius, XXYI, 8 ; Celsus, III, 4, II, 6, Carlius 
Aurelianus, Morb. acert., I, 15 ; Aquilejus, Florid., IV, 362 ; Plinius, 
Hist, N"at., VII, 37; and Saleh Beu Balah, Chap. 12. 

He recommended clysters of cold water for the aged, and for persons Water clys . 
troubled with stone or gravel, for females having falling or other affec- J^^ * he 
tions of the womb, and in all kidney affections when the bowels require 
moving. 



aged. 



64. Rhazes or Rasis, on Pestilence, written about 890 at Corcluba- andm«S« 
This book of Rhazes' is a curious and valuable record of the Arabian ~P° w e e s rJul 
practice in small-pox and measles. The best edition in Arabic and Latin 

is that by I. Channing, London, 1766. The doctor's theory is that of 
fermentation, and his practice is of the cooling kind, together with free 
evacuation of the bowels. 

There is also another translation of this book in English from the 
Arabic text by Dr. Greenhill (8vo*, London, 1847). 

65. Avtcexxa, or AbuAU Al Hosain Elm Abdallah Elm Sina, who intestinal 
was born in the year of the hegira 370 or 987 A. D., the first writer who *%*$ ~ 
formed a comrjlete system of rnedicine. was of opinion that evacuation of evaduaUon 

/,, 7 .• -i J -, J 7 7 7 ,/ • • • 7 the cure. 

the bowels, actively and per sever m r jLy employed, was the mam principle 
in tfte cure of disease. He was, however, more in favor of clystors than 



16 THE DOCTKINE OF PURGATION. • 

of internal purgative remedies, not considering that that method of pur- 
gation, often repeated in a proportionately short space of time, by its 
mechanical action, must prove injurious, causing ulcerations in the in- 
Coiic. testinal canal. Thus, when subject to a severe attack of colic, he took 
eight clysters in one day, which producing ulcers in the intestines, toge- 
ther with an epilepsy, a consequence of intemperance and sensuality, 
that had weakened his vital forces, thus causing his early death. Of 
his numerous books, said to be more than one hundred, his " Canon" 
and some tracts were printed in 1593 in Rome. 

Parey, Ambeose, M. D., Physician to Henry ITT., King of France 
and Poland. Paris, 1579. Transl. Thos. Johnson, M. D. Lon- 
don, 1634. 

Experience QQ, Although indeed we cannot deny but that experience has much 
thilcience! profited this art, as it has and does many others. For, as men per- 
ceived that some things were profitable, some unprofitable for this or 
that disease, they set it down, and so by diligent observation and mark- 
ing of singularities, they established universal and certain precepts, and 
so brought it into an art (Pref.) 



Hood. 



Disease 67. There is no disease which arises not from some one, or the mix- 

«y™f* tS wr " ture of more, humors. Which thing Hippocrates understanding, 
wrote every creature to be either sick or tvell according to the condition 
of the humors. And certainly all putrid fevers proceed from the 
putrefaction of humors. N"or do any acknowledge any other original 
and distinctive of the differences of abscesses or tumors; neither, do 
ulcerated, broken, or otherwise wounded members hope for the restora- 
PurgaMves tion of continuity, from other than from the sweet falling clown of 
removemor- humors to the wounded part, which is the cause that often in the cure 
from n the er of these affects. The physicians are necessarily busied in tempering the 
Hood. bloo.d ; that is, bringing to a mediocrity the humors composing the mass 

of the blood, if they at any time offend in quantity or quality. For if 
anything abound or digress from the wonted temper, none of the accus- 
tomed functions will be well performed. . . . Purging corrects and 
draws away the vicious quality of the blood (pp. 11, 12; cf. Hippoc. 29, 
30). 

Z°afhTeZ 68 - But witn tne blood at one and tae same time, all the humors 
the Mood in are made, whether alimentary or excrementitious. Therefore the blood, 
1 Sa r te.'' mal that it may perform its office, that is, the faculty of nutrition, must 

necessarily be purged and cleansed from the excrementitious humors. 

. . . The parts of which the blood is composed ought to be tempered 

and mixed among themselves in a certain proportion, which remaining, 

health remains^ but violated, disease follows (p. 12). 



an$£Zit a ^' J ^ mGua ^ 0n i s no other thing than the expulsion or effusion of 
ing. Thenat- humors which are troublesome, either in quantity or quality. Of evac- 
S morbid ion nations some are universal, which expel superfluous humors from the 
matter must wno le body ; such are purging, vomiting, perspiration, sweats ; some 



THE DOCTRINE OF PURGATION. 17 

particular, which are performed only to evacuate one part, as the J e ^ isted 
stomach by vomiting and stools, the guts by stools, the liver and spleen 
by urine and ordure. These evacuations are sometimes performed by 
nature, freeing itself of that which is troublesome to it ; otherwhiles by 
the art of the physician in imitation of nature (p. 37). 

70. The causes of congestion are two principally, as the weakness of fr0 m W morbid 
the concoctive faculty, which resides in the part, by which the assimila- ^ c n u s mul p lir 
tion into the substance of the part of the nourishment flowing to it by Purga- 



tion. 



is frustrated, and the weakness of the expulsive faculty ; for while the 
part cannot expel superfluities, their quantity continually increases (p. 
250). Those humors which are rebellious rather offend in quality than 
in quantity, and undergo the divers forms of things dissenting from 
nature, which are joined by no similitude or affinity with things natural 
(p. 252). A convenient diet arid purging must be used ; ill humors are 
amended by diet and purging (p. 253). 

71. Cancer. — The antecedent cause depends upon the default of frcmlmpur- 
irregular diet, generating and heaping up gross and feculent blood ; by $£ °£ the 
the morbific affection of the liver disposed to the generation of that 

blood ; by the infirmity or weakness of the spleen in attracting and 
purging the blood ; by the suppression of the courses or hemorrhoides, 
or any such accustomed evacuation. The conjunct cause is that gross 
and melancholic humor sticking and shut up in the affected part, as in 
a strait (pp. 279-80). 

72. The glands at the root of the tongue are very subject to inflam- jgJ^JJJ*: 
mations and swelling from crude, viscous humors. Swallowing is pain- gation and 
ful to the patient, and commonly he has a fever. Often the neighboring piications. ap " 
muscles of the throat and neck are so swollen together with these glan- 
dules that the passage of air and breath is stopped and the patient 
strangled. We resist this imminent danger by purging, by applying 
cupping-glasses to the neck and shoulders, by frictions and ligatures of 

the extreme parts, and by washing and gargling the mouth and throat 
with astringent gargarisms (pp. 293, 94). 

73. The dropsy is a tumor against nature by the abundance of Its ^™f e T~ 
waterish humors, of flatulences, or of phlegm, gathered one while in 

all the habit of the body, otherwhiles in some part, and that especially 
in the capacity of the belly, between the peritoneum and the entrails. 
From this distinction of places and matters there arise divers kinds of 
dropsies. . . . Yet they all arise from the same cause / that is, tlie weak- 
ness or defect of the altering or concocting faculties, especially of the 
liver, which has been caused by a scyrrhus, or any great distemper 
(pp. 299, 300). 

74. The beginning of the cure must be with gentle and mild medi- ^^rgSuimS 
cines ; neither must we come to a paracentesis, unless we have for- and' diuret. 
merly used and tried these ; therefore, it shall be the part of the 
physician to prescribe a drying diet, and such medicines as carry away 

water, both by stool and urine (p. 301). 



18 THE DOCTRINE OF PURGATION. 

Tetanus, 75 Tetanus — Causes. — Abundance of humors causes ~ repletion ; 

from excre- ■>-,-, i • -1 i • ~\ • t •• /» 

■mentitious dulling the body by immoderate eating and drinking, and omission 01 

ma ers. exerc i se or anv accustomed evacuation, as suppression of the hemor- 

rhoides and courses, for hence are such like excrementitious humors 

drawn into the nerves with which they, being replete and filled, are 

dilated more than is fit, whence, necessarily becoming more short, they 

pw^atiwi suffer convulsion. ... It is cured by discussing and evacuating remedies, 

a medidnes al as P ur g m g> digestive local medicines, exercise, frictions, and other things 

&c. which may consume the superfluous excrementitious humors that possess 

the substance of the nerves and habit of the body (pp. 329, 30). 

Note. — Allcook's Porous Plasters applied along the spine from neck to os sacrum, and 
Brandreth's Pills two every two hours, is good treatment for lockjaw. 

from^Struc- ^' P^V- — The cause are humors obstructing one of the ventricles 

tion bymor-" of the brain, or one side of the spinal marrow, so that the animal 

ma er. f acu ]t Y — the worker of sense and motion — cannot, by the nerves, come 

to the part to perform its action (p. 332). 
Purgation In the cure of the palsy we must not attempt anything, unless we 

have first used general remedies, diet and purging, all which care lies 

upon the learned and prudent physician (p. 333). 

Erysipelas ^' ^ r y 8 W e ^ as : — The cure of such an effect must be performed by 
Purge, but two means ; that is, evacuation and cooling with humectation. If bile 
do not bleed. a i one cause this tumor, we must easily be induced to let blood, but we 
must purge him with medicine evacuating bile (p. 353). 

Note. — Bleeding must never be resorted to in Erysipelas ; it is dangerous, never does 
any good, and is certain to retard the cure. 

r 78. The cure of gangrene, caused by the too plentiful and violent 

TherapSau* defluxion of humors suffocating the native heat, by reason of great 
phlegmons, is performed by evacuating and drying up the humors, 
which putrify by delay and collection in the part (p. 456). ... If the 
body be plethoric, or full of ill humors, you must purge (p. 455). 



ous humors 
must be eva 
cuated. 



Ulcers re 
quire always 



79. An ulcer has one, and 'that a simple indication, that is, exsicca- 
tion. . . . Before you do anything about the ulcer, you must first use 
Ih2? a xt^ £ enera l m eans; for in Galen's opinion, if the whole body require prepa- 
naiappiica- ration, that must be done first, for in some ulcers purgation alone will be 
tlons - sufficient (p. 470). . . . Dry ulcers you shall correct by humeating 

medicines, as, fomenting it with warm water, &c, but always you must 
first purge. . . . Then you must have recourse to refrigerent things 
(p. 471). 

Note. — The Gum Elimi Universal Cerate should be procured. We can recommend it. 
It contains no grease or oil, but is a vegetable production, and very useful in all affections 
of the skin ; as an application to a felon or otherwise it is superior to bread or linseed meal 
as a poultice. 

t£fofiht 80, Ophthalmia can proceed from different causes, external and 
eyes. Purge internal, producing the settling of humors to the eye. The evacuations 



THE DOCTRINE OF PURGATION. 



19 



of the matter flowing into the eye, shall he performed by purging medi- 
cines, cupping the neck and shoulders with scarification or without-, 
and lastly by frictions, as the physician shall think it fit (p. 645). 

Allcock's Porous Plasters are superior, applied to back and shoulders, to cupping, scar- 
ifications or frictions. 



81. The Diabetes is a disease wherein presently, after one has drunk, 
the urine is made in great plenty, hy the dissolution of the retentive fac- 
ulty of the veins, and the deprivation or immoderation of the attractive 
faculty. The causes are the inflammation of the liver, lungs, spleen, 
hut especially of the kidneys and bladder. . . . For the cure of so 
great a disease, the matter must be purged which causes or feeds the 
inflammation (p. G88). 



Diabetes. 
Evacuate the 
morbid mat- 
ter which 
causes in- 
flammation. 



82. Whenever the guts, being obstructed or otherwise affected, the 
excrements are hindered from passing forth, if the fault be in the small 



guts, the effect is termed " Yoloutus, Iteos, or miserere mei ;" but if it 
be in the greater guts, it is called the " colic," from the part affected, 
which is the colon. Therefore Avicen rightly defines the colic as "a 
pain in the guts, wherein the excrements are difficultly evacuated by 
the fundament." Taulus Eleginata reduces all the causes of colic to 
four heads, to wit : to the grossness or toughness of the humors impact 
in the coats of the guts ; flatulencies hindered from passage forth ; 
inflammation of the guts ; and, lastly, the collection of acrid and bit- 
ing humors. . . . Over-eating and taking in of nourishments that do 
net agree with each other, or with the constitution of the body, produce 
crudity and obstruction, and at length the collection of flatulencies, 
whereon a tensive pain ensues. . . By the use of crude fruits and too 
cold drinks the stomach and guts are refrigerated, and the humors and 
excrements therein contained are congealed, and, as it were, burned 
up (p. G89). . . . 



Colic. 
The causes 
and physiol- 
ogy. 



83. There is also another cause of the colic which is not so common, 
to wit, the twining of the guts, that is, when they are so twined, folded 
and doubled, that the excrements, as it were, bound in their knots, can- 
not be expelled.* . . . The colic is cured, the humors being first atten- 
uated andj diffused, and at length evacuated by medicines taken by the 
mouth and otherwise (pp. 690, 91). 



Enter ocele. 
Cure by pur- 
gallon. 



* Some sweet oil, followed by a dose of Brandre 
to relieve such painful state of the bowels. Also, 
should be given. 



h's Pills, is the simple remedy by which 
clysters of water, about summer heat, 



84 Arthritis, or Gout, is a disease occupying and harming the sub- Gout. 
stance of the joints by the falling down and collection of a virulent *£ ^{t\l°l 
matter and humors. "When there is a great abundance of humors in a genera^ dis- 
body, and the patient leads a sedentary life, not some one, but all the festingitBeiit 
joints of the body are at once troubled with the gout (p. 097). ioca£ nt 



20 



THE DOCTRINE OF PURGATION. 



Tlie causes. 
Intemper- 
ance, un- 
timely sleep, 
want of ex- 
ercise, pro- 
duce accum- 
ulation of 
morbid mat- 
ter. 



Imperfect 
purgation 
in diseases 
also pro- 
duces gout. 



85. The causes. of gout are unprofitable humors which are generated 
and heaped up in the body, and in the process of time acquire a virulent 
malignity. Such humors arise from an inordinate diet : they offend in 
feeding who eat much meat, drink strong wine, sleep presently after 
their meals, and use little exercise. For hence a fullness and obstruc- 
tion of the vessels, crudities, and the increase of excrements, especially 
serous, and, if they flow down into the joints, without doubt they 
cause this disease. Besides, also, the suppression of excretions accus- 
tomed to be voided at certain times. 

. . . Those who recover of great and long diseases, unless they be 
fully and perfectly purged, these humors falling into the joints, which 
are the relics of the disease, make them become gouty. The humor 
impact and shut up in the capacities and cavities of the joints, it cannot 
.be easily digested and resolved. The humor then causes pain by reason 
of distention or solution of continuity, distemper, and besides the viru- 
lency and malignity which it acquires. The concourse of flatulencies 
and hinderance of transpiration increase the morbific painful distention 
in the membranes, tendons, ligaments and other bodies of which the 
joints consist (p. 700). 



Cure: 
Purgation, 
regular to be 
had in spring 
and autumn. 



86. To cure the gout there are two indications : the first is the evacu- 
ation and alteration of the peccant humors, the other the strengthening 
of the weak joints, accompanied by a fit diet. ... A fit time for purg- 
ing is the spring and autumn, because gouts reign chiefly in these 
seasons (p. 704 ; cf. Hipp. Aph. 55, S. YI). 



GOLDEK WOEDS. 



Purgation 
must be 
strong, 
gradually 
increasing. 
It cures also 
the incident 
fever, and is 
the treat- 
ment requir- 
ed through- 
out the 
course of the 
disease. 



87. N"ow, it is convenient that the purge be stronger than ordinary, 
for if it should be too weak it will stir up the humors, but not carry 
them away, and they thus agitated will fall into the pained and weak 
joints, and cause the gout to increase. . . . The fever accompanying 
the gout easily becomes continual, unless the belly being first gently 
purged, nature be freed by stronger purges of the troublesome burden 
of the humors. . . . Seeing that physic is the addition of that which 
nature wants, and the taking away of those things that are superfluous, 
and the gout is a disease that has its essence from the abounding 
humor, certainly, without the evacuation of them, we cannot hope to 
cure either it or the pain which accompanies it. Metrius, in his treatise 
of the gout, writes, that it must be cured by purging, used not only in 
the declination hut also in the height of the disease, which we have 
found true BY experience (p. 710 ; cf. Hipp. Aph. 23, sect. I, and 
Aph. 8, sect. II.) 



sciatica. 88. Sciatica. — Strong purgatives are here also useful, such as used in 

purged and phlegmatic causes. Often vomitings do not only evacuate the humors, 
but also make a revulsion (p. 720). 



vomits. 



89. The heat or scalding of the water arises from repletion, inanition 
or contagion. That from repletion proceeds from too great abundance 



THE DOCTRINE OF PURGATfON. 21 

of blood, causing tension and heat in the urinary parts, whence proceeds 
the inflammation of them and the genital parts. . . . Purgings are cmebjput 
convenient, and a diet abstaining from heating articles, together with Q ati °n- 
cooling external applications (pp. 738, 740). 



Buboes. 



90. Bilboes, or Swellings in the Groins. — The matter of these for the 
most part is abundance of cold, tough and viscous humors, as you may Senate the 
gather from the hardness and whiteness of the tumor, the poverty of the 'purgation. 
pain and contumacy of cure ; which also is a reason why the yirulency 
of this disease may be thought to fasten itself in a phlegmatic humor. 
The cure shall be performed by detergent medicines, and the humor evac- 
uated by a purging medicine (p. 746). 



Tetters, 
Jiing-uorm, 



Small- Pox 
and JIe-( isles 
om impu- 
ity of the, 



91. Tetters, Ring-worms or Chops. — For general remedies, the distem- 
per of the liver and habit of the body must be corrected. This may be 
done by diet conveniently appointed, by purging and alterative- medi- &c" u i>ur'g7. 
cines, as they acquire their matter from salt phlegm or adust bile 
(p. 754). 

92. !Now, the Small-Pox is pustules, and the Measles spots, which 
arise in the top of the shin, by reason of the impurity of the corrupt blood 
sent there by the force of nature (p. 757). You must neither purge nor 
draw blood, the disease increasing or being at its height, unless perad- /' 
venture there be a great plentitude, or else the disease complicate with uSoSt 
others, as with a pleurisy, inflammation of the eyes, or a squinancy* which 
require it, lest the motion of nature should be disturbed, but you shall ^au^f 
think it sufficient to loose the belly with a gentle clyster ; but when the pu ' 9a 
height of the disease is over, you may with cassia, or some stronger 
medicine, evacuate part of the humors and the relics- of the disease 

(p. 759). 

* Quinsy. 

Parey was plainly unacquainted with the good effect of jDurgation in the early stao-e of 
Small-Pox, when the purgative employed was efficient yet innocent. 

In many thousand cases the Brandreth Pills have been administered, more or less dur- 
ing the course of Small-Pox, and with evident advantage in every case. 

These Pills are very useful where ])atients cannot obtain a doctor, and there are 
thousands of towns in the United States where there is not a medical man within one hund- 
red miles. 

The following letter from Daniel Bissell, of Xewcomb, Essex County, New York, who 
was supervisor of the town for twenty years, may be important. I consider it my duty to 
publish it here : 

MR. BISSELL' S LETTER. 

Four persons cured of Small-Pox by purging with BraJKdretKs Pills. 

Newcomb, Essex Co., IS t . Y, Sept. 13th, 1861. 
Doctor Benjamin* Brandreth, New York. 

Dear Sir: In our family we have used your excellent Pills for several years, and have 
found them to be a never-failing remedy in mild and severe cases of sickness, but their full 
value we did not fully appreciate until last winter, when the Small-Pox visited so many fam- 
ilies in this and the surrounding towns. I was first attacked, and supposed I had a cold ; 
took four Pills and some warm drinks ; next day no better, look four more ; still no better, 
and my wife said I should take eight—did so, and then the Small-I'ox began to show itself. 
On the fifth day took to my bed, and in less than four days was covered from head to foot 
with pustules. I continued to use the Pills daily, and took no other medicine whatever 



22 THE DOCTEINE OF PURGATION. 



except your Vegetable Universal Pills. The Pox was less than four days in coming to a 
head, and in about the same time they dried up. I began to attend some to my stock in 
about two weeks, but in three weeks I was attending to my regular farming business, having 
quite recovered my usual health. I took eighty Pills during my sickness, in doses of four 
to eight Pills, according to effect, being careful to procure two or three evacuations a day ; 
and though covered from head to foot with the disease, yet it has not left a mark upon me, 
which is one of the benefits said certainly to be secured by the U3e of Brandreth's Pills. I 
and my family found this to be so in our experience of their effects in this fell disease. 

My wife, well known as Aunt Polly for one hundred miles around us, was attacked with 
the disease about the time 1 was getting well of it. From the first she understood it was 
the Small-Pox, and prepared herself to combat its virulence by a free use of the Pills. In 
six days, and while confined to her bed, and scarcely able to move from excessive weakness, 
she used twenty-six Pills, or a little over an average of four Pills per day. And what was 
the consequence of this continued purging with Brandreth's Pills ? On Tuesday she was 
obliged to take to her bed; by Friday the pustules were all filled; and by the following 
Tuesday she had dressed herself! and in one week after was attending to her regular house- 
hold duties, to the astonishment of all her neighbors. One fact deserves notice : although 
she was covered with the disease, yet it has left no mark whatever on her skin, which bears 
no evidence of the awful ordeal it has passed under. 

Mrs. Wctherbee, my daughter, her husband, and their only child, were all stricken down 
by the Small-Pox. Mrs. W. had it light, and only some seven pustules came out. She used 
thirty Pills in fourteen days. Alonzo, her husband, had a severe attack, and took the Pills 
all through it, the number not noted. They both recovered in fourteen clays from its com- 
mencement. Their little boy, Daniel, about fifteen months old, had the disease badly ; we 
had little hope to save him. He was covered from head to feet ; he was like a huge scab; 
and for days he lay insensible. TVe all supposed he would die — that nothing could save 
him. His bowels had been confined for several days, and my wife said this must be reme- 
died — that perhaps if the boy could be purged he might revive. She read over yours and 
Dr. Lull's experience, and gave him one Pill, crushed, in some warm water. The Pill pro- 
duced no effect, but she was impressed with your remarks upon the necessity and import- 
ance of having the bowels purged in Small-Pox, and in all serious sickness whatever ; so she 
gave him another Pill. Still no effect. She then pounded three Pills, and added warm 
water, and gave them to the boy at once. Still no effect. There the little sufferer lay with- 
out motion, except the rapid breathing and peculiar signs of speedy dissolution evident to 
all. If he died, it would be said he might have got well had his bowels only been opened, 
and we then commenced to give him. three Pills in two hours, or at the rate of one and one- 
half per hour. When this child of fifteen months had taken thirteen Pills, they operated, 
and most fully. The stools were black as pitch, and most offensive. Every one was satisfied 
that it was death and mortified matter which the Pills had brought away, and that the Pills 
had saved another Kfe, through the Providence of God. 

In an hour after the Pills commenced to operate he began to revive, and took some re- 
freshment. He continued to improve until he got well. He is not marked with the disease. 
It seems proper to state that, though it took thirteen Pills to open his bowels, yet two days 
after he had a full natural evacuation without medicine, and his bowels have been regular 
up to this day, which is nearly nine months from the time of his sickness, nor has he u^ed a 
Pill since. He is as lively, intelligent, and healthy a boy as can be seen. His parents will 
ever be grateful to you, and they and myself and wife desire you to publish this letter, 
which, if need be, can be certified to by all the residents of. this and the adjoining towns. 
I am, respectfully, yours, 

DANIEL BISSELL, 

For many years Supervisor of the Town. 

We certify to the truth of the above. (Signed) — Polly Bissell; Aloxzo Wetherbee; 
Mary Wethkrbee; Russell Root, Postmaster, Schroon River; Erastus P. Root; Thomas 
R. Carey, Justice of the Peace, Town of Long Lake ; Cyrus H. Kellogg, Supervisor of Town 
of Long Lake, 1860; William Wood, Commissioner of Roads, Town of Long Lake ; Josiah 
Wood, Raquette Lake ; ^Vm. Helms, Forked Lake; W. H. Plumbley, Forked Lake ; Amos 
Hough, Forked Lake ; Ezekiel Palmer, Long Lake Hotel. 

ANOTHER CURE OF SMALL-POX. 

HOW TWO MEN WERE TREATED. 

I may also in this connection introduce the following statement of Joseph Daily, of No. 4 
Union Square, New York : 

Joseph^ Malone and Henry Downs, acquaintances, on the same day were taken sick. 
Mai one too'k ten Pills of Brandreth's ; next day, feeling no better, he took six more: still 
feeling no better, he took four more the third day ; fourth day better, got up and dressed 
himself, when, to his great astonishment, he observed large pimples on his face ; it was in 



THE DOCTRINE OF PURGATION. 23 

fact covered with Pox. Upon a further examination he found that they were coming out all 
over him; even the soles of his feet were full. Malone used the Pills more or less every day 
until he was perfectly recovered, which was within three weeks from the first day of sick- 
ness, when he was again at his business. Though covered from head to foot with the Pox 
they did not leave a mark behind. 

Henry Downs when taken sick called in a doctor, who discovered on the third day the 
true nature of the disease, and sent his patient to the Small-Pox Hospital on Blackwell's 
Island. There he remained two months, and then was discharged cured. €Ie lost an eye 
while in the Hospital, and was so marked that his nearest friends hardly knew him. These 
facts will bear the strictest investigation. 



WOKMS. 

93. A gross, viscid and crude humor is the material cause of worms, 
which having got the beginning of corruption in the stomach, is quickly 
carried into the guts, and there it putrefies, having not acquired the 
form of laudable chyle in the first concoction. This, for that it is viscid, STKmKm- 

tines ; eject- 
ed by pur- 
gatives. 



Worms 
from 'viscid 
humors ac- 
cumulated 



tenaciously adheres to the guts, neither is it easily evacuated with the 
other excrements ; therefore, by delay it further putrefies, and by the 
efficacy of heat, it turns into the matter and nourishment of worms 
(p. 765). In this disease there is but one indication, that is the casting 
out of the worms forth of the body, as being such that in their whole 
kind are against nature. . . . Now as such things breed of a putrid 
matter, the patient shall he purged, and the putrefaction repressed. . . . 
Oil of olives kills worms, and so do all bitter things (p. 767). 

Brandreth's Pills are infallible as a cure for worms, with or without olive oil. 

94. Leprosy proceeds from impurity of Mood. — You must understand 

that the cause of the leprosy by the retention of the superfluities, happens uaJt h m'' 
because the corrupt blood is not evacuated, but regurgitates over the Leprosy— 
whole body, and corrupts the blood that should nourish all the members, "rSy 'ofTte 
wherefore the assimilative faculty cannot well assimilate by reason of S/tSTm- 
the corruption and default of the juice, and thus, in conclusion, the P urit y a ? ii 
leprosy is caused. The antecedent causes are the ' humors disposed to regeneration 
adustion and corruption into melancholy by torrid heat. . . . Galen (ad 
Glauconem, lib. 1, cap. II.) defines it : " An effusion of troubled or gross 
blood into the veins and habit of the whole body " (pp. 769, 70). A 
cooling diet and purging shall be prescribed to evacuate the impurity of 
the blood and mitigate the heat of the liver (ibid. ; cf. 68 ; cf. 71, 82, 93 ; 
Hippoc. 42, 60). 

• 

95. Hydrophobia. — Such as have not their animal faculty as yet nydropho- 
overcome by the malignity of the raging venom must have strong pur- p^f^es 
gatives given them. For it is a part of extreme and dangerous madness f'? m h ^ in - 
to hope to overcome the cruel malignity of this poison already admitted 

into the bowels by gentle purging. . . Neither shall they let blood, lest Bleeding 
so the poison should be drawn further into the veins. But it is good ta-werous. 
that the patient's body be soluble from the very first (p. 789). 

Xote. — Brandreth's Pills, four every two hours, until twenty pills be taken, is the best 
means, and will hardly fail if resorted to in season. 



24 THE DOCTRINE OF PURGATION. 

96. The general and natural causes of the plague are absolutely two, 
from agU cor- that is the ^nfection of corrupt air, and a preparation and fitness of 
lnd te predis- corrupt humors to take that infection (p. 819). 

the Sod 1, ° f Humors -putrif y either from fullness which breeds obstruction, or by 
distemperate excess, or by admixture of corrupt matter (p. 820). 

97. I say that the pestilence does depend on the default of the air ; 
Abscesses this default, being drawn through the passages of the body, does at 

nature™ length pierce into the entrails, as we may understand by the abscesses 
that break out, by reason that nature using the strength of the expul- 
sive faculty, drives forth whatever is noisome and hurtful (p. 845). 

98. The physician must not let blood, for when nature is debilitated 
by this evacuation and the spirits, together with the Hood, exhausted, the 

^weeding venonloIls a i r w m soon pierce and be received into the empty body, 

where it exercises its tyranny to its utter destruction. ... If there be 

strong great fullness in the body, especially in the beginning, . . then it is 

Mate Twg- lawful to purge strongly. ... If you call to mind the proper indica- 

ing saves, tions, purging shall seem necessary, and that must be prescribed as the 

case requires, rightly considering that the disease is sudden, and requires 

medicines that may with all speed drive out of the body the hurtful 

humor wherein the noisome quality does lurk and is hidden (pp. 84:6, 

47). 

99. Concussion of the Brain. — By a heavy blow or the like occasion, 
the veins and arteries of the head may be broken. From hence pro- 

Concussion C eeds the afflux of blood running between the skull and membranes, or 
Purgation else between the membranes and brain. The "bload congealing there, 

indicated. causes vehement pain, and the eyes become blind, vomiting is caused, 
the mouth of the stomach suffering together with the brain, by reason 
of the nerves of the sixth conjugation, which run from the brain thither, 
and from thence are spread all over the ventricle ; whence, becoming a 
partaker of the offense, it contracts itself, and is presently, as if it were, 
overturned ; whence first these things that are therein contained are 
expelled," and then such as may flow thither from the neighboring parts, 
as the liver and gall, from all which bile is first expelled (p. 351). 

Brandreth's Pills in these cases purge in from thirty to sixty minutes. 

100. To cure a hroken and dislocated hone is to restore it to its 
in frac- former figure and site ; that is, first to restore the bone to its place ; 

tones and an second, to bring it to stay, being so restored; third, to hinder the 
operations increase of malign symptoms and accidents, or else if they happen to 
SfySeWood temper an d correct their malignity. . . . For this purpose we drive 
away the defluxion ready to fall down upon the part by medicines, repel- 
ling the humor and strengthening the part, or by appointing a good 
diet, hinder the begetting of excrements in the body, and divert them 
oy purging (pp. 565, 66). 

"Note. — The importance of purging and the reasons therefor are strongly presented by 
Ambrose Parey, and will have weight with sensible men, in or outside of die profession 



THE DOCTRINE OF PURGATION. 25 

Sa^ctoeius, M. D., Prof, of Physic at Venice ; Ars. de Statica medi- 
cina, Venice, 1614. Aphorisms, translated by John Quiney, 31. D. 
London, 1720 

101. If there daily be an addition of what is wanting, and a sublrac- The great 
tion of what abounds, in due quantity and quality, lost health may be he a wt p - le0 { 
restored, and the present preserved. (Aph. 1, sect. 1.) 



systematic 
disorgani- 
zation and 
reorganisa- 
tion. 



He only who knows how much and when the body does more or 
less insensibly perspire, will be able to discern when and what is t© be 
added or taken away, either for the recovery or presentation of health 
(Aph. 3). 

Note. — Nature herself does all these things, provided we relieve the body by purgation ; 
for innocent purgatives take out no humors but those which are depraved. 

102. Insensible perspiration is either made by the pores of the body, 
which is all oyer perspirable, and covered with a skin like a net, or it is 
performed by resp)iration through the mouth, which usually in the space ffonTiiow it 
of one day amounts to about half a pound (Aph. 5). isperorme . 

Note. — Should either of these processes of the skin or the lungs be partially suspended, 
we have only to increase by purgation the activity of the bowels, this organ measurably 
taking upon itself their work, they partially resting the while ; then both lungs and skin 
will soon regain their healthy functions. 



Insensible 
perspira- 



103. If the body increases beyond its usual weight without eating or stntic me . 
drinking- more than customary, there must either be a retention of the dici j ie • i ta . 

•it i • r> l • -i i a 1 fundamental 

sensible excrements, or an abstraction ot the perspirable matter (Aph. 9). principles. 

The body continues in the same state of health as long as it returns 
to its wonted weight, without any increase of the sensible evacuations ; 
but if it comes to its standard by larger discharges, either by stool or 
urine, than ordinary, it then begins to decline from its former health., 
(Aph. 10; cf. Parey, 71, 82, 93, 94 ; cf. Hippoc, 44, 45.) 



104. From too great fullness arise bad qualities, but none vice versa 



Plethora 



(Aph. 18). Too great a weight and fullness may be lessened by sensible requires 
or insensible evacuations, either of digested or undigested matter, and 
it is good so to do (Aph. 19). 



evacuation. 



Sweat (or 



105. That perspiration which is beneficial, and most clears the body 
of superfluous matter, is not what goes off with sweat, but that insensi- 
ble steam or vapor (Aph. 21). . . . which becomes sensible when there visible per- 
is too great a supply, or upon faintings, or upon violent motions (Aph. unheamy. 
22). Insensible perspiration accompanied with sweat is bad, because 

sweat diminishes the strength of the fibers. (Aph. 23 ; cf., Hipp. 29, 43.) 

When persons faint from severe purging, I have always observed that when they 
came to, the countenance appeared relieved from great anxiety ; perhaps a congestion was 
broken up, or some troublesome humor removed. 

106. The body is not presently thrown into a disease by an external 
injury, unless some of the viscera be first disposed to receive its impres- Predispo- 



26 THE DOCTRINE OF PURGATION. 

sition for, sions, which predisposition may be known by a greater or less weight 

?5£« ofa§- than is customary, and that not without some considerable uneasiness 

vancing du- (Aph. 39). The first impressions of a disease are much more easily 

mov'ecrudi- discernible from the changes of an unusual perspiration, than from the 

^Ztdtmte disorders of any of the other functions (Aph. 42). If, upon weighing, 

turn pwrga " the perspirable matter appears to have been obstructed, and there is 

neither increase of sweat nor urine for some days after, there is a great 

deal of danger of a putrefaction of the detained crudities (Aph. 43). If 

the obstructed matter can neither be removed by nature nor a feverish 

heat, there is immediate danger of a malignant fever. (Aph. 46 ; cf. 

Hipp. IT; cf. Hipp., 37.) 

107. The excrements of the guts which are well digested, are large 
Evacu«- %VCL hulk, but light in weight ; they swim because of the included air, 

*°% wlien and what is ejected at once seldom exceeds the third of a pound (Aph. 
72). 

108. Importance of Ventilation to Imperceptible Pores. — Nothing 
more tends to prevent a corruption of the humors than plentiful ventila- 
tion 01 ^ 6 the tion; not only by that which is drawn in by the lungs, but what is 
potS (active drawn in through the imperceptible pores. (Aph. 120; cf. Hipp., 10, 

and nega- 55 ano l 13, 26.) 
tive). ' J 

109. The plague is communicated not by any immediate contact, but 
PestiUn- either by drawing in infectious air or the steams of tainted furniture ; 

?£ l n, *Yow an( ^ it i s thus : the vital spirits are infected by the air, and from the 
propagated, infected spirits the Mood is coagulated, which produces black spots, car- 
ani ve cured bunches and buboes, and if not sufficiently discharged, occasion death; but 
uon. purga " if it he all thrown out, they escape. (Aph. 127; cf. Parey, 94). 

The above shows the absolute necessity of Brandreth's Pills in Plag-ue, because they 
purge safely. 

Air-~\is HO* The external air which passes through the arteries into the 

influence body may render the body heavier or lighter : lighter if it be subtle 

upon the ^ d ,, . -i ^ i • i t ° . / * -P ~ tt\ t 

body. and warm, and heavier when thick and moist (Aph. 3, sect. 11). In a 

foggy air perspiration is lessened, the pores are obstructed, and the fibers 
weakened and not rendered more firm ; and the weight of the retained 
matter is both perceivable and injurious. (Aph. 8 ; cf. 103, 106, 109.) 



Summer- 



Ill. Temperate persons weigh in summer time about three pounds less 

hoTit"en- tDan * n ^ e wmter (Aph. 23). 'That lassitude or weariness which is per- 

sues. its cure ceivable in summer time is not because the body is then heavier, but 

%rging nt to because it is then rendered weaker (Aph. 24). "in summer time the 

re 7t7ucted b ' D °d.y is not uneasy from the heat of the air immediately, for every part 

matter. of the body is even then hotter than the external air, but because at 

such times there is not a sufficient coldness to concentrate the natural 

heat. ~By which means it becomes so scattered that it cannot drive out 

the perspirable matter, in its own nature hot, by insensible steams ; which 

matter, by being retained, acquires a sharpness, and is really the cause 

of that uneasiness we are under from a sense of the summer heat (Aph. 

27, sect. 1) 



THE DOCTRINE OF PURGATION. 27 

112. When to Purge. — The autumn is unhealthful, both because per- Autumnal 
spiration lessens upon the supervening cold, and because that which is ob- SSStowS 
structed acquires an acrimony and a corrosive quality (Aph. 42). They |£ evdcuat- 
who are accustomed to a distemper in winter, that arises/ wm a fullness numtmu «c- 
^ humors, ought to purge in autumn (Aph. 48). tS™ U ' 

Note. — Our experience is, purge only when the body calls for it — when we have 
pain or oppression, or the bowels are costive. 

113. But for such diseases as* arise from noxious qualities, -purging spring the 
ought rather to be used in the spring than autumn, because in the hot puTJing/Z 
weather such qualities grow worse more than in the winter (Aph. 49 ; J^*""*'*" 
cf. Pare j, 86). 



114. If the obstructed perspirable matter acquires an acrimony, it pro- . Acrimony 
duces fevers and inflammations ; but when it offends onl y in quantity, and ™ 
it causes aposlumations, distillations, and cachexies (Aph. 51). 



corrected 
per- 
abundance 
carried off 
by purga- 
tion. 



115. When a full meal is not perfectly digested, it is to be known by an insensible 
increase of weight, for the body will not then perspire well ; but an exdetton- 6 
empty stomach is Med with vapors (Aph. 12, sect. 3 ; cf. Apo. 5, sect. 1.) |. h b J im e( ij 
Robust persons discharge their food for the most part by perspiration ; pending _ on 
those not so strong by urine ; and the weak chiefly by an indigested ai°strS#h. n " 
chyle (Aph. 14). A full or an empty stomach lessens perspiration ; for 

a full one diverts it by corruption of the aliment, and an empty one 
draws it back, that it may be filled (Aph. 11), and the obstructed mat- 
ter will acquire a sharpness, whence the body will be subject to distem- 
pered heat (Aph. 15). 

116. When a person seems to himself lighter than he really is, it is a sensation 
very good sign, because it arises from a perfect digestion of all the juices of health. 
(Aph. 19). 

117. That sort of food bast perspires, and affords the most suitable what la 
nourishment, whose weight is not perceived in the belly (Aph. 28). / ^ itable 

118. Nothing more frequently interrupts sleep than a putrefaction of watchful- 
the food, such is the sympathy between the stomach and the brain (Aph. morbid S 
40, sect. 4). From eating comes sleep ; from sleep digestion, and from te H^?% 
digestion a good perspiration (Aph. 59 ; cf. Parey, 99). stomach aml 

119. By exercise bodies are rendered lighter ; for all the parts, espe- Digestion 
cially ligaments and muscles, are cleared of their excrements by motion ; SXeof 5S 
the perspirable matter is fitted for exhalation, and the spirits rendered body - 
firmer (Aph. 9, sect. 5). Exercise promotes both the sensible and in- 
sensible evacuations ; but rest only the insensible (Aph. 10). 

120. The heavy part of the perspirable matter being more than usuallv " x?™™*- 

i • ,i -l i •, 'ii t i i* i ■• J ness 1 from 

retained m the body, it will dispose a person to tear and sorrow ; but obstructed 
the lighter part being obstructed, to anger or joy (Aph. 5, sect. T). Therefore" 

purge. 



28 THE DOCTRINE OF PURGATION. 



Harvey, William, Dr. — The works of, written 1628-51; transl. by 
Robt. Willis, M. D., and published by the Sydenham Society. London, 
1846-47. 



Harvey on 121. The blood acts with forces superior to the forces of the elements. 

the olood. . n i /-*{ ttt- i /y> • i 

As the instrument of the Great Workman, no one can ever sufficiently 
extol its admirable, its divine faculties. . . It penetrates everywhere, and 
is ubiquitous ; abstracted, the soul or the life, too, is gone, so that the 
blood does not seem to differ in any respect from the soul, or the life 
(anima) itself. At all events it is to be regarded as the substance whose 
act is the soul or the life. . . In one way the blood is part of the body, 
but in another way is the beginning and cause of all that is contained in 
the animal body. . . That which is abundantly nourished by it, in- 
creases ; what is not sufficiently supplied, shrinks ; what is perfectly 
nourished, preserves health ; what is not perfectly nourished, falls into 
diseases (pp. 510, 11). 

vitiated 122. Vitiated states and plethora of the blood are causes of a whole 

Mood. h ost f diseases (p. 391; cf. Hippocr. Works, p. 262, Yol. I., Aphor. 22, 

sect. 2 ; cf. Parey, 68-99). 

Nature the 123. The physiological consideration of the things which are accord- 
teacher of { n g | nature is to be first undertaken by medical men, since that which 
is in conformity with nature is right, and serves as a rule both to itself 
and to that which is amiss (p. 90 ; Hippocr. Works, p. 102, Yol. I., p. 
360, Vol. I). 

The timid . 124. Not yielding implicitly to the truth, he fears to speak out 
thrnewdoc°- plainly, "lest he offend the ancient physic" (p. 91). 

trine. 

125. Who will not see that the precepts he has received from his 

pie/of Ha!" teachers are false; or who thinks it unseemly to give up accredited 

vey'stime. p m i ons . or w h regards it as in some sort criminal to call in question 

doctrines that have descended through a long succession of ages, and 

carry the authority of the ancients ; to all these I reply : that the facts 

cognizable by the senses wait upon no opinions, and that the works of 

iva^ nature bow to no antiquity^ ; for, indeed, there is nothing either more 

authority. 63 ancient or of higher authority than nature (p. 123 ; cf. Hippocr. 47). 

The iiood 126. The blood is the generative part, the fountain of life, the first to 
again. Iwe^ the last to die, and the primary seat of the soul (p. 377). 

The blood is both the author and preserver of the body • it is the 
principal element, moreover, and that in which the vital principle (ani- 
ma) has its dwelling place. . . The blood, moreover, is that alone which 
lives and is possessed of heat while life continues (p. 379 ; cf. pp. 
£10, 11). 



THE DOCTRINE OF PURGATION. 29 



Collins, Samuel, M. D., System of Anatomy. London, 1685. 
127. Cathartics do not only affect the blood at a distance, but also the 



How pur- 
gative medi- 



the stomach 
and intes- 
tines, by irri- 
tation of the 

intestinal 
nerves, stim- 



villous coat and nervous filaments, which do immediately disturb them cines^act on 
with troublesome stroaks proceding from the pungent particles of pur- 
gatives, vellicating the inward coat of the stomach as a tender compage 
beset with nervous fibrils, which, irritated by sharp medicines, spew out 
serous liquor out of the excretore ducts, derived from the glands of the uTating 

• , .• peristaltic 

mtestmeS. motion and 

The purgation extract of medicines first produced by the ferments tne an m u!ous 
of the stomach, and afterwards imparted to the intestines, does highly matter. 
excite the nervous and carnous fibers, and gives a most troublesome 
sensation to the inward coat of the guts finely dressed with fibrils ; and 
afterwards affects the excretory vessels of the pancreas and hepatic ducts 
with a kind of convulsive motion, making them disgorge their pancreatic 
and bilious recrements, into the larger receptacle of the intestines. 

And not only the feces of the olood, secreted from it in the glands of 
the liver and pancreas, are thrown into the guts by the excitement of the 
nervous and carnous fibers, but also the extremities of the arteries and 
excretory vessels belonging to the glands, are opened by the sharp and 
aperient qualities of the purgatives, unlocking the secret pores of the 
inward coat of the intestines lined with a mucous matter, which is 
scraped off by the cleansing qualities of purgatives, leaving the intestines 
exposed to the active power of raking medicines, which force open the 
extremities of the arteries (p. 369, vol. 1). 



128. The concoctive faculty of the intestines is disaffected; first, as it pathology 
is wholly abolished, when no chyle, or very little, is extracted in the tines. 
stomach or intestines. This evil proceeds from the want of natural heat 
deficient primarily in the blood, and from a defect of good succus pan- f r ^ enUr lt 
creations, and bilious liquor, and a laudable serous and nervous juice, f^ c ^ n at f c 
not being imparted by the extremities of the arteries and nerves to the andpancre- 
crude aliment lodged in the guts. This disorder is commonly called cuVebyjwr- 
lienteria, an unnatural excretion of the aliment, little or no ways altered, o ative9 - 
wherein its compage is not well opened by due ferments, and a secretion 
made of the alimentary liquor from the grosser feces (p. 370). This 
obstruction of the hepatic and pancreatic ducts is cured by aperient medi- 
cines (p. 371). 



Cartiac 

■ffection is 

imperfect 

digestion 

from defee- 



129. Another disorder of the intestines near akin to the former, as 
differing from it in degree, is the lessened concoction, commonly styled 
caeliac affection, wherein the food is in some sort digested, and remains 
confused, as not secreted from the gross parts, because the chyle is not u"7 compo 
well attenuated by the pancreatic and bilious liquor, and serous and ^Si&Sg 
nervous "juice, which are destitute of volatile salt, oily and spirituous ^*f£? 
particles, so as to render the chyle fluid m the intestines ; whereupon the ive medi- 
clammy chyle embodying with the crude aliment, is excreted by the ex- 
pulsion faculty (p. 370). This distemper is cured by the same means as 

a lienteria (p. 371). 

130. The third indisposition of the concoctive faculty of the intestines imper/ect 

digestion 



30 THE DOCTRINE OF PURGATION. 

from acrid is its depraved action, produced by ill ferments of sharp bilious, and acrid 
Pwol ™' pancreatic liquor, vitiating the extracted aliment in the guts, and after- 
wards spoiling the mass^of blood, when it is received into association with 
it in the blood-vessels (p. 370). It denotes gentle aperient medicines (p. 
371 ; cf. Parey, 94). 

indiges- 131. Another disaffection of the intestines, and that none of the least 

Ssorders r °S because it concerns the nutrition of the whole body, is when the 
^twTfacui- distributive faculty of the chyle is either wholly taken away or much 
ty of the lessened, which may proceed either from the clamminess of the chyle, 
vucokty of or from the grossness of pituitous humors, more or less obstructing the 
orifices of the lacteal vessels seated in the intestines. The cure of this 
disease may be assisted with a light diet and medicines promoting the 
digestion (p. 371). 



humors. 



132. The intestines are also incident to divers diseases in reference to 
their expulsive faculty, when the peristaltic motion is too slow, or too 



Slowness 
of excretion 
from inact- 

iveness of quick, or aggrieved with the discomposure of pain 



nai nerves. The slowness of the motion of the guts proceeds either from the 
Pl stSia?e torpid indisposition of the nervous coat, not resenting the irritation by 
t vS'. toacU ' g ross excrements, when the nervous fibrils inserted into the inward coat 
of the intestines have their acute sense lessened, proceeding from the want 
of animal spirits intercepted first in the fibrous parts of the brain, and- 
by consequence in the nerves of the guts, produced by cephalic diseases, 
compressing or obstructing the fibrils seated in the brain. This dis- 
affection is cured by proper methods and medicines relating to the dis- 
eases of the head (p. 371). In all the diseases of the brain, Collins 
recommends purgatives to a greater or less extent (pp. 1133, 1134, 
1138, 1145, 1153, 1163, 1169, 1181, 1194, 1199 ; vol. II; cf. Sanctorius, 
118). 

Torpor of 133. The slowness of the peristaltic motion, incident to the guts, may 

fines *?rom ^ e a ^ so derived from narcotic medicines, dulling the acute sense of the 

narcotics nerves which terminate into the inward tunicle of the intestines, where- 

movX' by upon they are not sensible of their burden, when they are oppressed with 

gau!m. pur ' excrements. This disease may admit a cure by strong purgatives and 

sharp clysters (p. 372). 

Hardened 134. The remissness of the expulsive power of the guts may also 
moTed™ by arise from the viscid and indurated contents, produced by ill concoction ; 
purgatwes. ^q other from the heat of the guts, exhausting the liquid parts of the 

excrements ; the guts being overcharged with excrements, purgatives mav 

be advised (p. 372; cf. Hippocr. 13^25, 26). 

Lientery, 135. The over-hasty motion of the guts is made in a lientery and 

mfeanaidi- caeliac disease, proceeding from the quantity of crude and indigested 

Sited pe°r?- aliment provoking the nervous and carnous fibrils to excretion. This 

staitio mo- disaffection of the guts is visible also in diarrhea proceeding from salt 

by * purga- phlegm and from bilious and serous excrements discomposing the tender 

tvoe8 ' compage of the guts, and irritating them to expulsion. The cure of 



THE DOCTRINE OF PURGATION. 31 

this disease is performed by lenient and astringent purgatives (p. 372 ; 
cf. Sanctorius, 103 ; Hippocr. 44, 45). 

136. Inflammations of the guts producing dysenteries are most com- Dysentery 
monly seated in the great gut, which, proceeding from a quantity of m £iTn$™~ 
blood impelled by the mesenteric arteries into the intestines, some part of ^agnation 
which is stagnant in the substance of the bowels, and other parts are of impure 
transmitted sometimes into the small guts, where it seldom makes any io°weis. n 
long stay, as, being thrown from there into the colon, wherein the blood 
is long retained ; whereupon the tender frame of the coats is corroded 
by the sharp blood confined in the deep cavities of the colon (p. 372). 
The vitiated expulsive faculty of the guts coming from inflammations, 
and from an ill mass of blood, is cured by clysters made of healing 
medicines and by purgatives (p. 373 ; cf. Sanctorius,103, 106, 109, 110). 



Iliacpas- 
sion, or 

pains in the 



137. The iliac passion proceeds from divers causes, sometimes from the 
small guts, twisted, other times entangled and tied in knots, and also 
when they shoot downwards and upwards into one another. It may be ^maii '"guts 
derived from astringents unduly used, and from a stoppage of the intes- Sattontf 
tines by viscious matter from hardened excrements, and from flatulent {ene^i'iy^c- 
matter contained in the guts intercepting the passage of the gross companied 
feces. . . Now and then the upper shoots into the lower, and sometimes ness of thl 
the lower into the upper part of the small intestines, which are much W Mch *2 re- 
distended in several places, and in other parts contracted for some space ™jj. w b y 
both above and below ; whereupon the free play of wind being checked, medicines. 
the patient is highly tortured with pain," and, to ease himself, puts his 

body in divers postures by various agitations -and flexures of it. A re- 
laxation is made of some part of the guts adjoining the contracted parts, 
which, being moved forward by the pressure of wind toward the relaxed 
intestines, force them into the next expanded parts of the guts, which 
are afterwards closed up by the duplicature of them, entirely intercept- 
ing the passage of excrements. And when in this miserable distemper 
the lower part of the guts is thrust into the cavity of the upper, the 
pressing down of the excrements, made by art in purgative medicines, 
discharges the insinuation of the lower gut into the upper (pp. 375, 76). . 
The iliac passion may arise out of a gross alimentary liquor or phlegm 
concreted in the intestines, wholly shutting up the passage of them ; 
whence ensues a recoiling of the excrements upward, produced by the 
irregular contraction of the fleshy fibers (p. 377). This disease often 
happens upon a long suppression of natural evacuations oy stool, gener- 
ated by a load of hard excrements, long residing in the guts, productive 
of intolerable pains (p. 378 ; cf. Hippocr. 38, 41, 44). 

138. The colic is near akin to the iliac passion in the situation of the ret rarey. 
subject and in the cause of the disease, both proceeding from sharp S3) 
humors productive of vexatious pains, and from the great obstruction 
and tension of the guts, caused by a quantity of gross excrements, and 
more thin and flatulent matter (p. 379). This disease takes up its man- 
sion, if not solely, yet chiefly, in the colon. Colic pains are generally 
felt in the Icrwer apartment of the abdomen, accompanied with nausea, 
vomiting, suppression of stools, pains in the hack, &c. . . Colic, accom- 
panied with heat and beating pains, arises from blood impelled out of JtH 6?/mp . 



Colic: Ac- 
cumulation 
of stagnat- 
ing "bloody 
excrvnit-Ti/i- 
tioiix matter 
&n(\fl<i1vlen- 
ey,the cause. 



tf'ms. 



32 THE DOCTRINE OF PURGATION. 

the terminations of the capillary mesenteric arteries into the substance 
of the coats of the colon ; piercing and fixed pains come from sharp 
pancreatic liquor blended with viscid phlegm, or bilious humors lodged 
within the coats of the guts, which produce pungent and wandering- 
pains (pp. 380, 81). ." This disease denotes purging and alterative medi- 
cines (p. 382). 

Active,™- 139. I conceive the carnous and nervous fibers are much weakened 
~ lp ike by the inflation of the coats of the intestines, whereupon the irritation 



gation 
cure. 



of the medicines is not easily felt, and the carnous libers do not con- 
tract ; upon this account strong purgatives must be given, or rather gen- 
tle, often repeated, assisted with purgative clysters, which excite the 
peristaltic motion of the guts to discharge the indigested aliment or 
gross vitreous phlegm, or indurated excrements (p. 384 ; cf. Hippocr. 
• 55 ; Coll. 134). 

Abscesses 140. Abscesses and ulcers of the mesentery are cured by gentle purga- 

a oi d thJ c Zl tives and proper drying diet-drinks (p. 393). 

sentery. 

141. Great pains in the back are not the disaffection of the colon 
tu am lack only, but of the mesentery, too. . . Mesenteric affections are often de- 
di£ase 9 ° tb of rived from the serous feculencies of the blood, impelled out of the capil- 
lary arteries into the substance of the mesentery, and from flatulent 
and matter distending the libers of the mesentery. A cure may be attempted 
by emollient and discutient clysters and hy purgatives, gradually increas- 
ing their strength, and by fomentations (p. 395). 



tin inenenie 
ry — their 
causes 
cure by pur- 
gation. 



Diarrhea 
—full pur- 
gation. 



142. When patients labor under a great diarrhea, I conceive it very 
dangerous to advise powerful astringents until nature has fully discharged 
herself, or art emptied the guts of gross and more thin excrements (p. 
376 ; cf. Parey, 92, and Hippocr. 2). 

0pium 143. The immoderate use of opiates produces apoplexy, the drug 

the cause of stupifying and relaxing the nerves, and causing the stagnation of the 

apoplexy. ^^ ^ ^^ (p * n28) im ^ 

Apoplexy, 144. The sleepy diseases (apoplexy, cams, coma, lethargy), being 
itrong^pur 7 - a . kin in tneir causes > ar e m uch alike in their cures, too. . Strong purga- 
gation. tives may be given, and after a purgative has been celebrated, vomito- 
ries may be administered (pp. 1131, 1132, 1133). 

vertigo- 145. Vertiginous symptoms arise from irritation of the nervous 
K^ofSel nbrils of the stomach, intestines, liver, pancreas, spleen and kidneys, 
t^ainerves. proceeding from sharp recrements, which, offending the fibrils of the 

viscera, taking their origin from the brain, give a lightness to it (p. 

1136) ; and as to the preservatory indication in an ill habit of the body, 

purgatives may be applied (p. 1138 ; cf. 132). 

DeiiHum 146. In phreuitis and paraphrenias, produced by an undue effer- 

iti vescence of the blood caused by heterogeneous particles, or by the blood 

o£ihe bow- being poisoned with malignant qualities (p. 1140), which is induced by 

serous recrements vitiating the nervous liquor (p. 1143), clysters are 



THE DOCTRINE OF PURGATION. 33 

very successful to empty the towels of excrements and winds (p. 1145 ; 
cf. IParey, 94 ; Sanctorius, 109). 

147. Melancholy being produced by vitiated Hood and corrupt humors jJ^SSw 
in the viscera (pp. 1150, 1151), is cured by vomitories and purgatives, morbid 
removing the gross plilegm from the stomach and discharging gross, m blood! 71 
acid, and saline recrements from the blood (p. 1153). 

148. Mania borrows its first rise from an ill mass of blood, caused Mania, 
by the distemper of the hepatic glands not secreting the bilious from iiZd y by 
the more laudable parts of the blood (p. 1159). /Strong purgatives are f a u v % pur ~ 
used with advantage in this stubborn malady, as they purify the blood 

and nervous liquor (p. 1163). 



149. Frequent and large doses of opiates incrassate the mass of the Opiates 
blood (p. 1167) and nervous liquor, rendering tbem effete and vapid, so pishness 
that the brain cannot accomplish the acts of sense and reason, making 
men mopes and sots. To refine the blood, purging medicines, prepared 
with cephalics, may be very proper in those diseases (p. 1169). 



stupidity. 



150. The indication to take away the cause of epilepsy is principally fro ^%ti. 
founded in rectifying an ill mass of blood and nervous liquor, which a * ed state of 
depends much upon a laudable state of the viscera, so that the ill diathe- 
sis of the blood and viscera is taken away by vomiting, purging, and 
bleeding (p. 1181). 



toward cure ; 
purgation. 



151. Palsy. — The motive faculty is impeded or abolished, because Paisyivom. 
the origins of the nerves are obstructed by the grossness of the nervous f teXThe" 
liquor, which may arise from a thick, feculent, albuminous part in the %°fy ? r °- 
blood (p. 1193). A palsy sometimes succeeds severe pains of the stomach imperfect 
and intestines (p. 1194), which are produced by an accumulation of bilious The>>2sfe P 
and excrementitious matter and hardened feces and dilatation by flatu- 
lency, compressing the beginning of the vertebral nerves and intercept- 
ing the current of the circulating fluid (p. 1195). The antecedent cause 
of palsy is an ill mass of blood generated by a bad diet, hard of digestion 
(p. 1196). Vomitories may be advised in a foul stomach, but purgatives 
and alteratives for a habitual palsy (p. 1199). In a palsy derived from an 
evident cause — a fall, stroke, or wound — the apertion of a vein may be 
proper, after an emollient and discutient clyster has been administered 

and rejected (p. 1198; cf. 139 ; Parey, 83 ; cf. 136, 137, 13i>). 

Sydenham, TnoMAs, M. D. TJie whole Works of that excellent practical Sydenham. 
Physician, written about 1686. Transl. Dr. Pechey. London, 1701. 

152. Though a purge does for the present raise a greater tumult in Purgatives 
the blood and other humors, on the day it is taken, and in the operation, soonest* ai." 
than was before, yet this injury will be sufficiently made up by the ad- best - 
vantage that presently follows; for it is found by experience that purg- 
ing quells a fever sooner and better than any other remedy whatever, 

both as it expels those filthy humors from the body, by which, as the 

■ 'lent cause, the fewer was occasioned} and if they were not peccant 

before, yet, at length being heated, concocted and thickened by the, fever, 



34 THE DOCTKINE OF PURGATION. 

Filthy hu- d muc ] 1 to render it more lasting (p. 432 ; cf. Hipp. Works, I., 174 ; 
?e r cedent n " W. Harvey, 391; Sanctorius, 103, 106, 109, 110; Collins, 136-138, 
151). 

Sweating 153. Purging preferable to Sweating. — . . . On the contrary, as 

ing ^com- that method which is busied in eliminating the febrile matters through 
Sougk na- "the pores of the skin is less certain, so it is more troublesome and 
feZts Cur h tedious ; for by it the disease is very often protracted many weeks, and 
sweating, the life of the patient thereby endangered. . . . For this reason I insist, 
cw-e-bjpu!- upon good grounds, that purging is more powerful than any other 
method for the subduing levers of most kinds, for though sweating is 
nature's own method by which she casts out febrile matters, and is more 



The rea- 



given genuine and commodious than the rest, when nature is left to itself 
most excel- ^ £ rg ^ ^ggg^g -^be aforesaid matter, and then, when it is well concocted, 
gently expels it through the- habit of the body. 

Yet art, how much soever it may seem to imitate nature, cannot 
arrogate to itself the privilege that it is able to cure fever certainly by 
sweating. For, first, art knows not by what means the peccant matter 
should be fitly prepared to undergo expulsion ; and if it should know 
this, yet it has no certain signs by which it should be admonished of the 
due preparation of it ; so that also it is unavoidably ignorant of the fit 
time for provoking sweat, which it is very dangerous to provoke rashly; 
while if the physician should, by purging, miss his aim in curing the 
patient, yet he will not hurt him (pp. 432-34 ; cf. Cxid. Harvey, p. 
286 ; cf. Hipp. 29, 43 ; Sanctorius, 105 ; Parey, 69 ; Hipp. 9.) 

ggP The above a highly important article. 

PcSZ?o° ral ^^' ^ ^ e niimors are retained longer in the body than they ought, 
DiLases^va- either because nature cannot concoct them and afterwards expel them, 
pSn 11 pr t°o or because they have contracted a morbific disposition, they become 
quality 7 an d f exalted into a substantial form or species, which discovers itself by this 
morbid mat- or that disorder, that is agreeable with its own essence. 

ters. 

Like pro- The symptoms of disease, though to the less wary they may seem to 
arise from the nature of the part which the humor possesses, are really 
disorders arising from this or that specific exaltation or specification of 
some juice in the body. For nature is as methodical in producing and 
ripening these as of plants and animals, unless the order of it be dis- 
turbed by some extrinsic thing (as purgation). The species of diseases 
depend on those humors from whence they were generated. (Preface.) 

in chronic 155. Chronic Diseases. — Nature has not an effectual method in these 
fistnaZrV.' diseases, to eject the morbific matter, as in acute, whereby, we assisting 
and aiming at the right mark, the disease may be cured. (Preface.) 

Note. — Purgation usually changes the chronic into an acute disease by assisting nature 
to expel impurities ; thus the blood becomes endowed with grea'ter vitality. 

Disease— 156. A disease is nothing but nature's endeavor to thrust forth, with 
a effort"!? 1 all her might, the morbific matter for the health of the patient, though 
cure - the cause of it be contrary to nature (p. 1 ; cf. Hipp. Aph. 2 ; sect. I ; 

Sanctorius, 106.) 



THE DOCTRINE OF PURGATION. . 35 

157. Impurities mixed with the blood affect the whole with a mor- why na - 
bific contagion, partly from the various ferments or putrefaction of ^peiimpu- 
humors which are detained in the body beyond their due time, because rities - 

it was not able to digest or evacuate them, either upon the account of 
their bulk being too great, or the incongruity of their quality (pp. 1, 2). 

158. What is the Gout but Nature's contrivance to purify the blood Gout - 
of old men (p. 2) ? 

159. Purification— r lNature performs this office, sometimes quicker, Fevers- 
sometimes slower, for when she requires the help of & fever, whereby she STf™™" 
may be able to separate the vitiated particles from the blood, and after- Wher \ , she 

i it liTi ••i • i i* -i i i cannot from 

wards expel them, the whole business is done m the mass of the blood, 



cannot from 
any cause 

and that by violent motion of the parts. . . . When this kind of matter thtse Vl hn P v- 

rities, Pal- 
sies, &c , and 

Chronic 
Diseases fol- 



is fixed to any part which is unable to exclude it, either upon the ac- 
count of its conformation, as it is in the morbific matter of a palsy that 
the nerves are stuffed with, or upon the account of a continued flux of Yo*Tl£m 
new matter, wherewith the blood is vitiated, which is only disposed to £2^? 
carry it off, does oppress and overwhelm the part. 1 say in these cases 
the matter is very slowly or not at all concocted, and so diseases that 
proceed from such unconcocted matters are, and are called, chronic 
(pp. 2, 3 ; Cf. p. 402 ; 19. ; W. Harv. 90, 391 ; Sanctorius, 112). 



160. He will not be mistaken much who should affirm that more 
diseases arise hence, viz., from the omission of purging after autumnal 
diseases, than from any other cause whatever (p. 21 ; Cf. Hipp. Aph. 
12, II. ; 43, 56, VI. ; Works, 707, II. ; 728, II. ; Aph. 32, IY). 



Diseases 
from want 
of purga- 
tion. 



161. All means to avoid disease or infection are useless, if the body is 
furnished with humors disposed to receive the infection (p. 59 ; cf. dise°ase, sc the 

HippOC. W. 102, I). oe°pur, mUSt 

162. Cholera. — Should I restrain the first effort with narcotic medi- choiera- 
cines and other astringents, whilst I hindered natural evacuation, and de- ^ ingent8 
tained the humors against nature, the sick would undoubtedly be 
destroved by the intestine war, his enemy being kept in his bowels (p. 

115 ; cf. Hipp. Aph. 2, I. ; 21, I ; Collins, 142). 



163. Sydenham on Hippocrates, Nature and Disease. — The excellent Hippocrates' 
Hippocrates who arrived at the top of physic, laid this solid foundation SS^ewS 
for building the art of physic upon, viz., nature cures disease, and he ijjjjj^jjj 
delivered plainly the phenomena of every disease, without pressing any piyadescrip- 
hypothesis into his service. He also delivered some rules gathered from Jure. °Ar?of 
the observation of that method that nature uses in promoting and "^S ne JJz° 
removing diseases, and of these things consisted the theory of the divine tnrecm\yby 
old man . . . This theory was nothing else but an exquisite description anTsimpie! 
of nature ; it was reasonable that in practice his only aim should be to 
relieve her, when she was oppressed, by the best means he could ; and 
therefore he allowed no other province for art than the succouring of 
nature when she was weak, the restraining her when she was outrageous, 



36 THE DOCTRINE OF PURGATION. 

and the reducing her to order, and to do all this in that way and manner, 
whereby nature endeavours to expel diseases ; for the sagacious man per- 
ceived that nature judges diseases, and does in all, being helped by a few 
simple forms of remedies, and sometimes without any (preface ; cf. pp. 
432,2-3; W. Harvey 123). 

164. Scarlet Fever. — I reckon this disease is nothing else than a 
moderate effervescence of the blood, occasioned by the heat of the fore- 
going summer, or some other way, and therefore X do nothing to hinder 
the depuration of the blood and the 'ejecting of the peccant matter 
through the pores of the skin, which is easily done by the blood itself. 

Puraaiives 1^5. ^^ wnen -th e scales are gone off and the symptoms ceased, I think 

cure, other it proper to puege the sick with some gentle medicine that is agreeable to 
remedies e- ^ g ^^ an( ^ strength ; and by this simple and plain natural method, this 
name of a disease, for it is scarce anything more, may be easily and 
safely removed. Whereas, on the contrary, if we disturb nature by 
cordials and other needless remedies too learnedly thrust in secundum 
artem, the disease is hightened and the sick dies by the over-omciousness 
of the physician (pp. 189-90). 

166. I think pleurisy is a fever originating in a proper and peculiar 
aSaTat- inflammation of the blood, an inflammation by the means of which 
tempt to cure nature deposits the peccant matter in the pleurae. Sometimes she lavs 

by elirm»at- , , , * , x r # i t -..^J 

ing morMd it on the lung itself, and then there comes a peripneumonia. This diners 
Zeliood,° m from the pleurisy only in degree. It exhibits the results of the same 
cause with greater intensity. (Society's Ed., vol. I., p. 247.) 

Harvey Gideon, M. D. The Vanities of Philosophy and Physick. 
3d edit. London, 1702. 

167. 1st. Things in philosophy and medicine which we do not know, 
uncertain- are beyond all manner of comparison more than those things we do 

ty in medi- knOW. 

2d. The greatest part of these things in medicine, which we pretend 
to know, is conjectural and uncertain. 

3d. Many if not most of these things which we do peremptorily 
affirm to be this or that, to be caused by this or that, or to cause and 
effect this or that, are or may be proved to be false (pp. 7, 8 ; cf. 
Parey, 66 ; cf. W. Harvey, 124-126). 

The Nood 168. The antecedent causes of most diseases are the fluid parts of the 
Seas? ° f blood, the fluid animal lympha, the glandulous lympha, and the blood 
being vitiated (p. 139 ; cf. F. Harvey, p. 391). 

Theory of 169. How True. — The weakness of the stomach and its faintly per- 
disease. forming its office, is only occasioned by the debility of the stcmach- 
nerves, and their various branches, by being plastered up by too much 
fleam, gross and acid dregs, indigestible meals, or offensive drinks, or 
other matter admitted into the stomach, which, by lodging there too 
long, assume a corroding quality. . . . (cf. Sydenh., Prof.). 



THE DOCTRINE OF PURGATION. 



37 



Strength- 
eners " do 



170. This supposed, I do believe, and have experimentally observed, 
that all those corroborations of the stomach, whose virtue is commonly 
asserted to consist in a gentle restrictive and warming quality — whereby not strength 
these slimy humors are more firmly cemented — so far from contributing 
the least strength to the stomach, being long continued, do carry danger 
with them (p. 227). 



171. The only means I have hitherto found to strengthen the stom- 
ach are proper abstersive medicines, gently wiping off those clammy sub- 
stances from the tunic of the stomach, and the terminations of the nervous 
branches. . . . Do only keep your stomach clean, you will certainly pre- 
serve its strength, and prevent most diseases (p. 228 ; cf. Hipp. Aph. 8, 
sect. II. ; Parey, 87). 



Purgatives 
the only 
strength- 
ened. 



172. Herodotus (in Euterpe) who was contemporary with Hippoc- 
rates, tells us that the Egyptians, to whom the first invention of physic 
is ascribed, used to take purging-physic, for three days together every fj^lf^ 
month, for no other purpose than to cleanse their stomachs, knowing they among the 
could be subject to no diseases but what the foulness of their stomachs Egyptians, 
might occasion, in regard their bodies were strong, and their air the most 
clear and temperate in the world, (p. 232). 



173. It is not to be understood, where a heap and weight of crudities 
is accumulated, that gently absterging remedies can have power to disen- 
gage the stomach, any more than a wet mop can be supposed to rid a room 
ot a heap of rubbish, — in which case something more stimulating is re- 
quired, that may be used in all seasons of the year, be it sultry or freezing, 
without the inconvenience of confinement to diet or warmth of air, or 
without offence to the stomach, or putting the body into any disorder ; 
to which purposes the pill I here now describe, I have experimentally 
found to be effectively answering in most respects, (p. 228). 



Full pur' 
gation. 



Brandretk's Pills are superior to the following in all the elements of cleansing physic. 

174. Take one ounce of the clearest shining aloes ; powder it in a 
mortar, covered over with a brown paper having a hole in the middle 
for a passage to the pestle. Observe to anoint thinly the bottom of the 
mortar and pestle with a little Florence oil, to keep it from sticking to 
the bottom. When it is reduced to a gross powder, by grinding it with 
the pestle you must bring it to a smooth fineness. Put the powder into 
a small glazed flat-bottomed earthen pan, that will contain about half a 
pint, pouring upon it about a quarter of a pint of water, wherein has been 
dissolved 2 drams of Spanish juice of Liquorish, which is done by slicing 
it very small and setting the water in a porringer over a gentleheat ; 
place this same earthen pan into one somewhat bigger, having sand in the 
bottom to the height of an inch, and afterwards filling it up to the 
brim. Set them over two piles of bricks of three or four bricks laid flat. 
The piles must stand at such a distance, that they may reach the edges 
of the bigger pan to support it. Then make a moderate fire of charcoal un- 
der it, to heat the same, to cause the superfluous moisture to be evaporated, 



The Har- 
vey nu. 



38 THE DOCTRINE OF PURGATION. 

until the aloes is brought to the thickness of honey. Or you may, by drop- 
ping two or three drops on the back-side of a plate, to cool, make a trial 
whether it be reduced to the consistence of dough ; for if it be over- 
done, the mass being rendered brittle, will not only lose most of its 
virtue, but also its aptness of being framed into pills ; and if it be not 
evaporated enough, it will be sticky, and not apt to be brought into a 
mass. The lesser pan being taken off, when the evaporation is sufficient, 
before it is quite cold, you must with a spatula or slice take out the mass, 
and between your fingers, being a little anointed with Florence oil to pre- 
vent the sticking, roll it into a round ball, w T hich you may keep in a 
sheep's-bladder, being likewise thoroughly wetted over on the inside with 
the same oil, for many months, if necessary. A small piece of this mass 
being formed into 6, 7, 8, or 9 little pills of the bigness of a pepper-corn, 
is a dose sufficient to give two or three motions. 

The safeness of this medicine adds much to its character, since the 
taking of one pill, or two, more or less, imparts as little hazard, as the 
taking it very often, or in any kind of season, be it hot or cold, &c. . . . 
By the addition of the use of Liquorish, the aloe is designed to be obtused 
in its too purgative qualities, whereby it is apt to raise the piles, and 
become somewhat less precipitating, &c. 

The same correction may be obtained by taking a large handful of Bug- 
loss or Borrage-leaves, and stirring half a pint of warm water with them 
in the bruising, and clarified by subsidence in letting it stand in a cellar 
for a day or two, and pouring it off the feces or dregs in the bottom. 
This evaporated in the same manner, will produce a mass almost equal 
in goodness to the former, (pp. 223-75). 

The whole of what follows in Paragraph 175 is equally applicable to Brandreth's Pills, 
whose virtues far exceed all other cleansing medicines the world has yet seen. 

175. I cannot but heretofore observe, that the use of these pills, though 
frequently taken, according to the time the stomach, by reason of its 
degree of weakness in the digestive faculty, may require, does in anywise 

Purgatives debilitate those that may properly use them ; but on the contrary, rath- 
er corroborate their stomach by assisting it, to throw off that heap of rub- 
bish and crude humors,, which those that eat and drink plentifully, and 
either live sedentary lives, as many that are educated to professions, or 
others that are not used to exercise or labor, are subject to engender, 
especially if naturally of a weak constitution or of an advanced age. 
(p. 235). (cf. Hipp. Aph. 8. Sect. I). . . For three or four days succeed- 
ing the use of these pills, a good Elixer projyrietatis taken morning and 
evening, in a proportionate dose, has, by my observation, ever had the 
good effect of preserving health and preventing disease, (p. 235.) 
(cf. Sydenh. 153). 

176. As lesser purgatives do rather contribute strength, by their con- 
Puraatives sequence, so the greater, being properly used, do not carry that danger 
strengthen with them people commonly imagine, since I have known many that, 
weaken. for three months successively, have taken strong churlish purging pills, ev- 
ery morning, some few days only omitted. I may say some have swallowed 
a bottle of strong purgative pills in a few years, and lived in full health 



do not weak. 
en. 



THE DOCTRINE OF PURGATION . 39 

to a remarkable old age, and not without a libertine mode of eating and 
drinking. Whence it is apparent, that the toughness of the nerves, upon 
which the strength and action of the bowels only depend, does suffer as 
little by the strongest purgatives, as an Indian cane by a thousand times 
bending, which notwithstanding will recover its former figure and full 
strength, (p. 236), (cf. p. 223). 



Our experience and the experience of all who have used Brandreth's Pills confirm these 
remarks on bleeding. 



1 77. It were to be wished that bleeding could be admitted with the same 
safety, of which it may be justly said, that the lancet has, and does in 
proportion kill more men, than the sword ; and it is as commonly observed, 
that those physicians who do so generally practice it, know little else 
what to do. (p. 236.) ... It is a consequence an idiot infers, because 
a person having been bled eight or ten times in a great distemper, does 
recover his health, he owes the benefit of it to the bleedings, whereas it 
ought rather to be said, neither the distemper nor the bleeding could 
kill him. (p. 237). 



ON LAUDANUM. 

178. I stand amazed at the folly of mankind that is so easily allured, 
by vain boasting and mendacious encomiums upon Laudanum Mquidum, 
plainly prepared or disguised ; to the frequent and constant use whereof 
a man being once debauched, under the pretence of ease, and quieting 
himself of a few gripes, fumes or vapors, he can no more leave it off for 
a fortnight, a week, or a day, than a laborer his bread and cheese, or a 
man throw off his coat and waistcoat in a hard winter, or a brandy- 
drinker forsake his spirits and return to small-beer. Using onesself to 
such plain or disguised opiates, after some months or a few years, is like 
making a contract with the, devil to live easy and well for a few years, 
upon condition he shall have his soul to torment afterwards. For certain 
it is, that the familiar use of opiates, after some months or- very few 
years, does wholly desist from being friendly, by suffering your trouble 
or distemper to return in a more horrible manner, or create a new one 
incomparably worse than the former, or strangles you with an apoplexy, 
or some other soporous distemper, which is most amply proved by those 
that make opium their sacred refuge in every fit of the gout, colic or 
stone, who seldom or never fail of a speedy exit, by some incurable dis- 
ease of the brain in very few years. And those that do advise such a 
lethiferous remedy for a common use to their patients, have a greater 
title to a halter labelled with an inscription of " Mathews' Pills," or 
" Pacific Drops," than those that murder a man on the highway, (pp. 
237-38.) ... In short all strong narcotic medicines occasion weakness 
of the stomach-nerves, numbness, palsies, lethargies, loss of memory and 
dullness of understanding, diminish and deprave all the offices, actions 
or operations of the bowels, suppress the appetite, occasion a wildish 
countenence and paleness, and at last, upon long usage, usher in death 
(pp. 238-39.) (cf. Collins, 133). 



Bleeding. 



Laudanum 
— its evils. 



40 



THE DOCTRINE OF PURGATION. 



Purgation 
preserves 

and pre- 
vents. 



179. To preserve health and prevent disease in valetudinary consti- 
tutions — for strong, vigorous bodies stand in no need of other preserva- 
tions or preventives, than moderation in their nonnaturals, the know- 
ledge and sense whereof nature has implanted in all other animals, as 
well as in man — no better ways and means can be used, than applying 
at certain intervals to those cleansers and abstersers before mentioned, 
(p. 239). 



LTemorr- 
Aoides. 



Harvey's 
Liniment. 



180. For those subject to LTemorrhoides, the following Liniment 
Electuary is recommended. Four ounces best Cassia Fistularis, newly 
drawn and evaporated to a consistency — the manner of doing it you may 
read in a treatise called the " Family Physician and House Apothecary " 
— Rhubarb, powdered, while Mechoacan, grated and powdered, and 
clean Rhenish (not cream of) Tartar powdered, of each a quarter of an 
ounce, Sweet Fennelseeds, powdered, a dram and a half, Syrup of Mash- 
Mallows, as much as will suffice to make them into an electuary, (pp. 
239-40). Take half an ounce or an ounce, dissolved in a quarter of a 
pint of thin gruel, barley-water, posset, or thin chicken-broth, according 
to directions given concerning the aloetics. (p. 240). 



Harvey\ 
Emetic. 



181. In Headaches from over-eating or drinking, in Apoplexies, 
Palsies, Fevers, <&c, when purging medicines are too tedious in their 
transportation through so long a space, as the roundabout of the guts, a 
vomit that will throw up immediately through the gullet, by a short 
passage, the whole burden at once and operate kindly, without disturb- 
ing any of the other bowels, or raise a mud in the humors — antimonial 
vomits are excluded, as being too long before they operate, too churlish in 
disturbing all the bowels, and exciting a violent commotion in the 
humors. Ipecacuanha, that new fangle, brought by the French from the 
West Indies, is the root dried of a mere common juncas whereof, in the 
places where it grows, you may buy a cartload for a two-penny looking- 
glass, or a penny-worth of bugles, though at Paris they have the confi- 
dence of selling it at thirty or forty livres a pound, — which, notwith- 
standing, our asarum-root does far exceed in the operation — than which 
there can not be a more unacceptable drug to the taste in the world, 
&c. . . Take the purest White Vitriol, one and a half ounce, being pow- 
dered and ground very fine, put it into a glass bottle-bolt-head, pour 
upon one and a half pint of springwater, and half a pint of clean English 
Spirits, once rectified, which they call Double Spirits. Close your bolt- 
head with a cork and a wet bladder over it, tied with packthread. 
Place the bolt-head standing upright in a sandbath and let it digest, with 
a moderate warmth, twenty-four hours. But remember to shake the 
bolt-head very well, before you place it in the sand. After this digestion 
decant the liquor gently into a glass funnel, wherein is placed a coffin of 
cap-paper folded according to art, and so let it filtrate into a glass bottle. 
When it is almost quite passed through to the quantity of a spoonful, 
take out the funnel and throw away what is left. If you filtrate it a 
second time over, it will be the clearer and more depurated. This is a 
very easy, gentle and safe vomit, operates nimbly, and for cheapness ex- 
ceeds all others. It may be kept always ready upon every occasion, 
without making any bustle, and so lasting, that its virtue continues for 



THE DOCTRINE OF PURGATION. 41 

many years ; and for the most part it will move a stool or two, whereby 
it carries off those crudities that are remaining in the stomach, or that 
are escaped into the guts. When you find occasion for using the vomit, 
you must pour out three, four or five spooufuls, according to your easi- 
ness or difficulty to vomit; but commonly three spoonfuls is enough. 
This must be mixed with double the proportion of warm small-beer or 
warm water, wherein a little Carduus has been boiled, or thin gruel ; 
then drink it off. If this do not operate in a quarter of an hour, take a 
spoonful or two more, or you may load yourself with carduus boiled in 
water until you vomit. This may be taken safely in the beginning of 
most distempers without any further consultation, (pp. 244-45). 

Gideon makes a grave mistake in respect to Ipecacuanha. It is one of the best and most 
safe roots ever applied to the use of man, as a vomit or purgative. It is one of the ingredi- 
ents of Brandreth's Pills. When a vomit is needed take four Pills, and drink hot boneset 
tea, and your stomach will surely discharge its contents. 

182. About throwing off the febrile matters by sweat 

. . . Whether diaphoretics ought to be used before the declination theirSSand 
of a fever, at. which time only they appear to be healthful in assisting f mparedf s 
nature to throw off, for it must be owned by all experienced practition- 
ers that the causa febr His, be it vicious humors, heterogenous particles, 
or what other offensive they are pleased to allow, must be first sub- 
dued, or digested and separated, before it can be expelled by sweat ; and 
therefore, should you exhibit the largest doses of diaphoretics that nature 
can possibly bear, and second them by loading the patient with a num- 
ber of bedclothes, he will scarcely be brought to sweating ; and if, per- 
adventure, he should happen to be forced into a sweat at the augment or 
state of the fever, it must be a very great detriment. . . Supposing, 
fictitiously, that diaphoretics were proper, the tmcertainty of their oper- 
ation would often occasion a failure of the effect that is expected from 
them. Purgatives and vomitories seldom or never fail in their operation, 
if justly dosed, but sudorifics and diuretics very often, though adminis- 
tered in great quantities (p. 286 : cf. Sydenh., pp. '432-434). 

The advantage of Brandreth's Pills is that they require no care, and whether taken in 
large or small doses are sure to be of service. In full doses the beneficial effects in all se- 
vere diseases are at once evident. And when the system requires a vomit they usually act 
on the upper passages of the stomach. But the additional use of hot boneset tea, after a 
dose of four or six pills, is sure to act as an emetic and without any danger. Some gruel 
should be ready for the patient to take after the vomiting is over ; this is needed, when sleep 
will follow. 

■ 

Harvey, James, M. D. Prcesagium Medicum. London, 1720. 

183. In delirious distempers great hopes of recovery are had from 

all sorts of evacuations, chiefly because they check the velocity of the D p ff e in 
blood, diminishing its quantity, take off* its obstruction, and relax the 
nerves (p. 10). 

184. Pains, especially if they be fixed a long time in any of the 



42 THE DOCTRINE OF PURGATION. 

noble viscera, impair the strength of the patient, and obstruct the circu- 
imp^5±ies. n lation of the blood, concoction, and secretion of the humors. . . But in 
acute disease it is accounted a sign of recovery when pains invade the 
legs and feet, and happen upon a crisis or signs of it. 

185. But though such pains speak an impetus of the blood and force 
The Crisis. f na ture to throw off the matter of the disease upon those more igno- 
ble parts, yet, when they go off without any apparent cause, as the ad- 
ministration of medicine, or natural evacuations, the humors may be 
justly suspected to have returned into the mass of blood* by which the 
case is rendered more dangerous than it was, and a happy event of a 
crisis in acute distempers, depending upon mere chance, or a favorable 
turn of nature, is always uncertain and never to be relied on (p. 30 ; cf. 
Sydenh. 432 : M. Harv. 391 ; G. Harv. 139 ; Collins, 130V 

How na- 186. In the ordinary and natural motion of fluids that serve 'either 

imYrS™ ^ or n " Q trition or excretion there are necessary passages or channels 
or otherwise through which they run easily, but in extraordinary cases, as all diseases 
them. 363 ° f are, nature finds out extraordinary ways by which it throws out the 

noxious matter, or at least puts it in a less dangerous place (p. 43 ; cf. 

Hippoc, Edinb. ed. Epidem., lib. ii., sect. 5 ; Parey, 69). 

187. The- animal life depends upon many and different causes, and 
Life^maith an integrity of all the parts of the body, especially those that are prin- 

Disease. cipal, as the head, heart, arteries, and veins, and the liquors that run in 
them, namely, the blood, chyle, &c. But because our bodies cannot 
always continue in the same state, its parts, both solid and fluid, being 
worn, consumed, and dissipated by continued motion, there must be a 
continual supply of food for its reparation, as well as proper instruments 
and vessels, in which it may be prepared and made fit for that nurpose. 

188. Nature, therefore, has contrived the stomach, intestines, and 
The stom- ^ an ^ s -> m which, by a wonderful mechanism, our food is pounded and 

ach. ' concocted, and its grosser parts separated from those that are more fine 
and subtle, the one for the preservation of life, and the other as the 
useless, to be thrown out by emunctories ordained for that end. But 
when those instruments are defective — which often happens — and the 
muscular force of the stomach is insufficient to grind the food and make 
a chyle of fine parts, that which we receive for nourishment and repara- 
tion of our todies not being duly prepared, is so far from being useful 
that it is rather hurtful to us. For this unconcocted food or crudity 
entering into the mass of blood, renders it viscious, tough, and of a clary 
substance, unfit for motion and circulation, and the cause of most dis- 
eases (cf. Collins, 137 ; Sanctorius, 109, 101*). . . 

189. Whatever, therefore, is useless to the. body, or inconsistent with 
the blood, must be separated from it, that it may be preserved in a per- 



At these times an extra dose of Brandreth's Pills should be administered. 



THE DOCTRINE OF PURGATION. 



43 



feet state. Hence the endeavors of nature, and the contrivance of the 
intestines, cuticular glands, and other emunctories appropriated indeed tines, J anT 
to their peculiar excrements, but sometimes common to all or most of them SS.JSSf*" 
(p. 92 ; G. Harvey, 163). 



190. Evacuations by sweat are to be attempted with the greatest 
caution, not. indiscriminately by all persons nor at all times. For if 
medicines to procure it be given when the blood is of a texture not open 
enough — which it cannot be near the beginning of most feverish dis- 
turbances — or when too heterogeneous substances abound in it, forced 
sweats often er dispose the blood to stagnate in the tender vessels of the 
brain and nerves than to separate its noxious particles at the designed 
secretory parts (p. 129 ; cf. Sydenh., pp. 432-434 ; Gid. Harv., p. 286) 



Forced 
Sweats — 
their danger. 



191. Nature — by which I mean the effects of matter and motion, 
according to the laws and constitution of animal economy — is indeed 
the great physician and cure of disease ; so that now-a-days several dis- 
turbances are happily taken off by the slightest remedies, or by a mere 
abstinence from them. But, in acute diseases, the die is cast for life or 
death, and in this case nature is not to be altogether relied on ; neither 
must we, as the advocates for the doctrine of crisis, patiently wait for 
the issue of the conflict between nature and the disease, the peccant 
humors of some fevers being sometimes so stubborn, that art must in- 
terpose to promote their evacuation some other way. (pp. 207-8.) (Cf. p. 
92 Sydenham, 163, 166.) 



Assist na- 
ture by pro- 
moting evac- 
uations. 



"Will ax, J., M. D., An Essay on the King^s Evil. London, 1735. 

192. The diminution of the morbific matter, both in the primae vim 
and whole body, is to be effected by cleansing that canal, and evacuating 
the morbific matter out of it ; and by this means we cannot fail of 
lessening its quantity in every other part of the body. (p. 21.) (Cf. J. 
Hamilton, 218.) 



Diminish 
the morbid 
matter, and 
you lessen 
th e cause of 
disease. 



Purging with Brandreth's Pills infallibly lessens the quantity of impurities; and as they 
are harmless to the most tender age, or the weakest or most feeble, they can be used every 
or every other day, reducing the sum of unhealthy matters contained in the body, and thus 
taking an extinguisher or weight from the blood, whose vitality becomes thereby increased, 
and all the parts of the body be duly nourished into e renewed life and vigor. 



Pren'gle, Sie John, 
1753. 3d Ed., 1761. 



M. D., on the Diseases of the Armies. London, 



193. Early Sweats. — It has been usual to give the theriaca, or some Mout 
other hot medicine for this purpose ; but all such increase the fever, if sweats. 
they fail in bringing out the sweat (p. 131). 



ness 



194. The bilious or remitting fever of the camp begins with chilli- » ;K 
lassitude, pains of the head and bones, and a disorder at the stom- and remit- 



tent fevers — 



ach. At night the fever runs high, the heat and thirst are great, the symptoms! 



44 



THE DOCTRINE OE PURGATION. 



Nature's 
effort at cure 

complete 
when evacu- 
ations are 



tongue is parched, the head aches violently, the patient gets no better 
and often becomes delirious, but generally in the morning a perfect 
sweat brings on a remission of all the symptoms ; in the evening the 
paroxysm returns. These periods go on daily, till the fever changes 
insensibly either into a continued, or into an intermitting form. Some- 
times loose stools carry of the fit and supply the sweats. Although the 
fever most frequently appears in the form of a quotidian, yet sometimes 
it is to be seen in a tertian shape I remember of no natural evacua- 
tions making a complete cure, unless when a violent discharge super- 
vened of the corrupted bile, or other humors which seemed to be the cause 
of the disease (pp. 165-67). (Cf. J. Harvey, 190.) 



Sweat. 



195. When the sweat is abundant, the putrid parts of the blood are, 
either wholly or in some degree, expelled, after which the fever is either 
entirely cured, abated or brought to intermit, (p. 183,) (cf. 194.) 



Evaeua-' 196. On bilious fevers in Britain. — Instead of evacuating or correct- 

ions pre- i n ~ w h a t is amiss, we often neglect it, till it ends in obstructions of the 

vent many p 7. & J t • . • t *h 

forms of viscera, oo that hence may proceed nervous complaints without lever, 
or fevers of a nervous hind, instead of fluxes, intermitting or remitting 

thorough cor- 



fevers, the common consequences 
ruption of the humors, (p. 200.) 



of a more sudden and 
(Cf. Collins, 132, 135.) 



why the 197. We may observe that the fibres are more relaxed in the spring 
the 'fittest is than in the winter; hence that the body becoming more plethoric, the 
humors will then be apter to corrupt, upon any suppression of perspira- 
tion. And this may perhaps be forwarded by the effluvia arising from 
all putrid substances which, being locked up during the cold of winter, 
are then set at liberty by the greater heat of the sun. (p. 201.) 



sett son to 
purge. 



Dysentery. 
Excellent ob- 
servations 
concerning 
the use of 
purgatives. 



Opiates 
and astrin- 
gents are 
most danger- 
ous pallia- 
tives. 



198. Dysentery. — We must at all times attend less to the dose than to 
the effects, which are never to be judged of by the frequency but by the 
largeness of the stools, and the relief the patient finds from tlie gripes 
and tenesmus after the operation. The motions are generally more fre- 
quent from the disease alone than from the purgation. As on the one 
hand, the physician must avoid all the rough and stimulating purges, so 
on the other hand, he is not to spare those of a lenient kind. (p. 240.) 
The necessity of continuing the physic is to be determined more by the 
obstinacy of the gripes and tenesmus, than by blood in the stools. 
Without such frequent evacuations, it is in vain to attempt a cure / as all 
opiates and astringents by themselves only palliate and lender the disease 
more fatal in the end. (p. 241.) (Cf. Sydenham, 162 ; Hippocr. 8. Gr. 
Harvey, 175, 176.) 



Opiates 
" fix the 
cause " of 
the disease. 



199. As to opiates, it were better they were never used at all, than 
given before the first passages were thoroughly cleansed ; for though they 
afford some ease, yet by penning up the wind and corrupted humors, 
they fix the cause. This I presume to affirm from repeated experience. 
1 am well assured, that the fluxes I have seen in the army, are never to 
be cured without evacuations, (p. 241-42.) (Cf. J. Harvey, 191.) 



THE DOCTRINE OF PURGATION. 45 



200. In some cases the patient would seem likely to recover, but 



Hardened 



would relapse upon voiding hard scybala which, coming away in small f eC es the 
parcels for several days together, made a constant irritation. These, 
therefore, were to be speedily removed by a full dose of rhubarb with removed be 
manna, or by some other lenient physic, (pp. 245-46.) (Cf. Collins, lescence en 
134, 139, 151.) 



sues. 



201. Palsy. — Of purgatives the most active should be selected, and 
such as influence most energetically the principal secreting viscera ; as p a uy— 
calomel, colocynth, jalap, scammony, &c. In paraplegia, and even in q^Ions. pur " 
hemiplegia, the bowels are very torpid, and require repeated and full ^' e ^ e f a 
doses of those, and even of still more energetic cathartics, as croton-oil, gia. 
or elaterium, in some obstinate cases. In many cases recourse should 
also be had to purgative enemata. It is not merely necessary regularly 
to evacuate fecal matters by means of these, but to employ them so, as to 
derive from the cerebro-spinal axis any increased flow of blood to it, 
which may have occasioned, or prolonged the attack. Indeed, with 
these conjoined objects, they are advised by Halle, Dalberg, Brodie, and 
others, who have insisted on their use. (p. 242.) (Cf. J. Harvey, 183 ; 
J. Harvey, 171, 175, 179.) 

I have advertised the above sentiments for forty years, at an outlay of more than a mil- 
lion of dollars, and long before I saw the above able remarks. 

I now insert the following testimony, which applies well to Sir John's remarks. 

The following was published in 1863. It tells its own story: 

SANITARY COMMISSION. 

" What is it doing to economize the Life and Health of our Soldiers ?" 

" Is it using all the means Providence has placed within its reach, or is it stiff-necked, 
and determined that so great a remedy as BRANDRETH'S PILLS shall not be used to econ- 
omize the life and health of our Soldiers ?" 

Sagacious men believe that the administration of BRANDRETH'S PILLS, in its 
" Homes" and as " Special Relief " would more than quadruple the present value to the 
"Life and Health of our Soldiers." 

Let the following testimony from sixty returned volunteers be studied by members of the 
United States Sanitary Commission. If the statements be true, can they be doing their 
duty as Christian Men in not using the means Providence has placed within their reach ? 

FRIENDS OF SOLDIERS— READ ! 

JBrandreth's Pills protect from the arrows of disease, usually as fatal to soldiers as the bul- 
lets of the foe. 

Sing Sing, October 26, 1863. 

We, the undersigned, surviving members of Company F, Seventeenth N. Y. Volunteers, 
hereby certify that we have used Brandreth's Pills during our two years' service, and to 
them we attribute the fact that our constitutions are uninjured by the necessary hardships 
and privations of a soldier's life in the field. In costiveness, colds, chills, diarrhoea, dysen- 
tery, and typhoid fever, their prompt use cured us in a few days. Our health was often 
restored without having been entered on the sick list ; in fact, a single dose of four or five 
pills usually cured what, under the regular treatment, would have been a serious sickness. 
Others, who appeared to be sick in noway different to us, but who used the remedies pre- 
scribed by thr- regimental surgeon, either died or were sick for weeks in the hospital. 

When we left Sing Sing, in June, 1861, you gave us a supply of these Pills, and we feel 
sure, from our experience, that if every soldier was supplied with this medicine, the gen- 
eral health of the army would be greatly improved. For ourselves, it is our sole remedy, 
answering all our wants in the way of physic, and we have known and tested it from our 
childhood, and our parents before us. 



46 THE DOCTRINE OF PURGATION. 

John Vickars, Captain ; J. J. Smith, 1st Lieutenant ; William See, 1st Sergeant ; G. H. 
Dearing, 2d Sergeant ; Dennis Shay, 3d Sergeant; Patrick Cullen, 4th Sergeant; Benj. F. 
Brown, 1st Corporal ; fm. Mathers, 2c? Corporal ; Noah W. Miller, 3d Corporal ; Theodore 
Crofut, Drummer ; Geo. B. Coe, Drummer. 

Francis J. Jenning, William W. Campbell, William J. Charlton, Albert Wesley, John W. 
Griffin, William Holmes, William W. Rider, Martin See, George Ackerly, Hiram Seagle, 
Alfred Wilkins, William Griffin, George Ayles, William J. P. Hewett, John L. Branden- 
burgh, Thomas A. Barlow, Henry Hannah, William Waldron, John Conover, Jacob Baker, 
Lewis B. Coy, Albert Lane, Ellis Jones, Wm. Van Wert, James B. Crofut, Roscoe K. Wat- 
son, Frederick Hunt, William Tuttle, Jotham Carpenter, Charles Wright, Sanford Olmstead, 
Fuller Carpenter, James Bentley, Robert W. Westcott, Jacob H. Dyckman, John M. Bodine, 
James N. Hines, Edward Waldron, Warren Wright, David Baker. 

T. B. Lane, 1st Lieut. 38th N. Y. Vols. ; M. C. Larle, 1st Sergt. Co. D, 17th N. Y. Vols. ; 
Wm. Knight, Co. I, 6th N. Y. Artillery ; Millard F. Lanning, Musician, 1st IS. Y. Vols. ; 
Wm. Kenney, Co. R. Berdan's Sharpshooters; Cassius Bishop, Co. E, 38th N. Y. Vols.; 
Elliot See, Co. B, 38th N. Y. Vols. ; Daniel Gillis, Sergt. Co. B, 3d N. Y. Vols. ; Caleb S. 
Frisbie, Co. B, 5th N. Y. Vols. 

State of New York, Westchester Co., ss. : 

I, William M. Skinner, a Notary Public, duly commissioned and sworn, residing in the 
Tillage of Sing Sing, County and State aforesaid, do hereby certify that the names of the 
sixty persons subscribed to the Certificate hereto annexed, dated October 26, 1863, concern- 
the value and efficacy of Brandreth's Pills, beginning with Capt. John Vickars and ending 
with Caleb S. Frisbie, were signed in my presence, and that I, at their request, witnessed 
their signatures to said Certificate. 

I further certify that I am well acquainted with all who signed said Certificate, and 
know them, individually, to be men of truth and veracity. 

In witness whereof, I have hereunto subscribed my name and affixed my official seal, 
this eleventh day of January, one thousand eight hundred and sixty-four. 

WM. M. SKINNER, Kotary Public. 

State op New York, County of Westchester, ss. : 

I, Hiram P. Rowell, Clerk of the County aforesaid, and also Clerk of the Courts in and 
for said County, do hereby certify that Wm. M. Skinner, Esq., whose name is subscribed to 
the Certificate of the Proof or acknowledgment of the annexed Instrument, and indorsed 
thereon, was, on the day of the date of the said Certificate, a Notary Public, in and for 
said County, residing in the said County, appointed and sworn, and duly authorized to take 
the same according to the laws of the said State. And further, that I am well acquainted 
with the handwriting of the said Notary Public, and verily believe that the signature to the 
said Certificate is genuine. 

In-testimony whereof, I have hereunto set my hand, and affixed the seal of the said 
Courts and County, the 12th day of January, 1864. 

HIRAM P. ROWELL, Clerk. 

Cullen, William, M. D., First principles of medicine , London, 

1777. 

Fevers. 202. Fevers. — Sweating employed to prevent intermittent fevers, has 

ofuT l dun- often changed them into continued fever, which is always dangerous. 

gerous. ^ ^^ 

Urging the sweat, may produce hurtful determination to some of the 
internal parts, and may be attended with very great danger, (p. 166. f-) 

Robertson, Robert, M. D., An essay on fevers, <&c. &c. JBooinson, 

1790. 

203. Idiopathic fever. — Whenever men complain of being seized 
with chilliness, or alternate chills and heats, headaches, sickness at stom- 



THE DOCTRINE OF PURGATION. 47 

ach, universal pains, or as the sick express themselves "pains all over 

them ; or pains in all their bones, or joints, especially in their loins and nf^'erai 

back, with less or more debility ;" and if their countenance is at the same charact ^- 

time obviously diseased, whatever the other symptoms accompanying 

these are, I can, from experience, assure the reader, that a most virulent 

infection is present (p. 59). 

204. Whatever has a tendency to debilitate the system., may either fe ^"is % 
be a remote or aproximate cause of fever, according to the constitution of that *f>iiv- 
the patients. A sufficient reason may be assigned for many people being tem. 
seized with fever at the same time ; which is, their being exposed to the 

same debilitating powers of heat, cold, draught, or wet, or sudden 
changes of these (p. 88). 

Miller, Edward, M. D., Inquiry concerning cutaneous perspiration 
and the operation and uses of sudorific remedies. New York, 1793. 
Medical Keposltory, 1T98, vol. II; See Med. <& Phys. Joum. 1799, 
Vol. I. 

205. That sudarifics can not be usefully employed as a general remedy jr everftare 
in fevers, is apparent from the fatal course pursued bv many of these not cured by 
diseases, notwithstanding the most copious, universal, and continued 
sweats, spontaneously taking place. The memorable sweating sickness, 

which first appeared in England, towards the close of the fifteenth cen- 
tury, and was one of the most fatal epidemics on medical record, affords 
ample proof of this position (Journ. p. 288). 

206. On the whole it may be concluded, that much of the use of Errors 

n . n i • i* • j_ i a j • ji j_ i? about siceat- 

sudorifics has arisen irom mistaken doctrines, concerning the nature oi ing. 
perspiration and of fever, particularly from the erroneous opinions, that 
the matter of perspiration is excrementitious ; that its occasional obstruc- 
tion is noxious ; that it ought as much as possible to be eliminated from 
the system ; and that it is only carried off, in considerable quantity, when 
discoverable by sight or touch (ibid). 

207. It may be also concluded, that sudorific remedies, especially 

those of the more powerful kind, are, in general, highly unsafe, and cal- U n" a fTand 
culated to augment the violence of inflammatory and malignant fevers ; injurious. 
and, that though they may succeed in some cases of less violence, or by 
a favorable concurrence of circumstances, yet they are so constantly 
liable to produce mischief, and exasperate the disease, that the abuse, on 
the whole, must be pronounced greatly to overbalance the use (ibid). 

Selle, H., M. D., Professor in the University of Berlin ; new con- 
tributims to physical and medical knowledge, Berlin, 1798. See Med. 
& Puts. Journ. 1799, Vol. I. 



208. Puerperal fever. — This disease originates in an accumulation of 
corrupted humors in the abdomen, which humors have either been al- 
ready separated in the form of milk, or intended by nature to be so. "X'"- "'"'"- 



Puerperal 
fever, from 
accumula- 
tion of mor- 
bid matter 



48 THE DOCTRINE OF PURGATION. 

The causes of this accumulation may be various, but are principally an 
epidemic miasma, passions, sudden cold, and inflammation (Part III. 
p. 92). 



In corroboration of Professor Selle's theory," Dr. Hermbsteadt has 
proved by chemical experiments, that the fluid matter found in the cavi- 
ties of the abdomen was virtually milk. It deserves, however, to be 
remarked, that the fat of the omentum and the mesentery, being dissol- 
ved by the febrile heat, may combine with the extravasated lymph, so as 
to produce a fluid of a more or less viscid consistence, and resembling 
milk in its external characters (Journ. p. 387). 



Bache, "William, M. D.. On a successful case of Asthma, Birming- 
ham, 1799. See Med. & Phys. Jouen. 1 < 99, Vol. II. 



Asthma. 
Acidity of 
the secretion 



209. I became convinced that an acid pervaded the whole of the 
circulating system, and I presumed that it existed in a morbid degree, 
the cause, either as to quantity or strength, and was the exciting cause of the 
spasmodic affections observable in the lungs, and other membranous parts, 
to which it might occasionally be applied, probably sometimes in a gase- 
ous state, and at others in a more dense and concentrated one, and per- 
haps variously combined. The indications of cure suggested to my 
mind were to restrain its influence, and my attention was principally 
directed to the state of the stomach, the bowels, the expectorations, the kid- 
neys and the skin (p. 141). 



Coneadi, D. G. C, M. D., Resident Physician ai Northeim, Ger- 
many. Practical remarks on the most prevailing species of cramp in the 
stomach. See Med. & Phys. Jouen.. 1799, _Vol. I. 

210. The affection is not violent in the beginning, but a pressure, and 
Cramp in stricture, and griping, rather than an acute pain, is felt in the region of 
*its S Sse^" the stomach. The patient has an oppressive sensation, as if something, 
neglect of no t unlike a nail, were fixed behind the stomach : if the attack increases 
KeoawSdi- in violence, he complains of stitches in the breast and towards the back, 
causl by the and endeavors to procure relief by shifting his posture. The principal 
paroxysms are observed to take place generally in the afternoon, in con- 
sequence of bodily exercise immediately after dinner, the use of acid food 
and drink — and particularly after giving way to gusts of passion, such 
as terror, anger, grief, and anxiety. 

This affection is often contracted by persons subject to passionate emo- 
tions, on their neglecting to take an emetic occasionally • it is not, in 
general, attended with acidity, but rather and most frequently is pro- 
duced by a bilious acrimony ; and it at length almost invariably degene- 
rates into a nervous habit (Jour. p. 49). 



THE DOCTRINE OF PURGATION. 49 

Dexmax, Thomas, 31. D., On a case of dropsy in the ovarium. See 
Med. & Phys. Jouebt. 1799, Vol. II 

211. After giving the history of a female patient, who had suffered Dropsy of 
from violent pains in her bowels, tension of the abdomen, and much i-omcon™?- 
soreness on pressure, accompanied with vomiting, constipation, and fre- P ation - 
qnent fainting, symptoms which were chiefly relieved by clysters and 
gentle purgatives, hemorrhages from the uterus, violent pain in the low- 
est part of the back, and, on pressure upon the sacrum or hip, in the 
neighboring parts, Dr. Denman says : There was great tension and pain 
above the " ossa pubis," and the whole hypogastric region was full and 
hard. She discovered a large hard tumor, extending to the right side of 
the navel, the increase of which was so rapid that in the course of a few 
days it occupied the whole abdomen. She was then freed from pain in 
all the parts contained in the pelvis, could lie on either side, and walk 
much better. She frequently after this had slight shivering fits, and a 
sense of coldness down her back, followed by restlessness and feverish 
heat, especially in her hands and feet in the evening, which went off 
with a free perspiration toward morning. Her pulse was at all times 
very quick. TJwugh one or more stools had oeen regularly procured 
evenj day, an immense quantity of hardened fences, of a large volume, 
were now discharged for three or four successive days, by which her size 
was much lessened. She had been treated for sciatica. When I first Regular 
visited her, the whole abdomen was distended by a circumscribed tumor evacuation 
springing from the right side, near the groin, thence extending across, 2J3T 1 * 



accu- 



and high up in the abdomen, and I thought I conld feel an obscure fine- Nation 
tuation in it. 1 could also feel an angle of the tumor in the posterior 
part of the pelvis, by which the " os uteri " was projected so high and 
so far forwards as to be almost beyond my reach, as is the case in the 
retroversion of the uterus. She was not pregnant. I did not therefore 
hesitate in the opinion that it was a dropsy of the ovarium ; and by sup- 
posing this, early in the disease, to have dropped low down in the pelvis, 
and afterwards to have risen according to its increase, all the symptoms 
which had occurred could be satisfactorily explained. I directed only a 
strong purging draught. On the following day, she informed me that 
after suffering considerable pain in the bowels, she had four or five 
cox-)ious motions, and that after every motion she was sensible of her 
size decreasing. The motions were unusually offensive, and, before they 
came away, the desire to expel them was unnaturally urgent and pain- 
ful. On examining them, I found that they almost wholly consisted of 
a gelatinous fluid, with many streaks of blood, and with little or no mix- an [°Z e ?>{^i- 
ture of faeces. Instead of feeling weakened by the evacuation, the f£iff* r0a ~ 
patient felt herself very much relieved. The medicine was continued for 
two days more, producing the same number of motions ; the swelling of 
the abdomen had gone, the os uteri had descended into its proper posi- 
tion, and no tumor whatever remained in the cavity of the pelvis. I 
concluded that, in consequence of preceding inflammation, an adhesion 
had taken place between the cyst 01 the tumor and some part of the in- 
testine, probably the rectum, the adhering portion of the bowels had 
given way, and, by that opening, the contents of the tumor had been 
evacuated. She was perfectly restored to health (pp. .20, 22). 

Let the reader examine the Van Wart case at the end of these quotati 



50 THE DOCTRINE OF PURGATION. 

Henderson, Stewart, Surg. Practical remarks on the diseases 
which occurred on hoard of II. 31. Ship Astrea, on the Jamaica station, 
(&c. See Med. & Phts. Jotjrn. 1799, Vol. I. 

212. Remittent or Marsh-fever. — This fever, the legitimate offspring 
/eo/r^from of all hot climates, especially where marshes abound, is the autumnal 
marsh efflu- g^ sease f m ost parts of Europe, only appearing in a milder degree. It 
"there is h as "b een described under various names — bilious, yellow, Jamaica, Sene- 
vEK,"butun- gal, and in Bengal, pucka — but multiplying distinctions which do not 
mld>fica- mt exist only serves to perplex and mislead, for it will be found to ~be the 
tions. same individual disease, under different modifications, depending on 

constitution season of the year, and local situation. The cause of this 
fever, in all its varieties, is marsh effluvia. We find that in some places 
at the Cape of Good Hope, where no such cause exists, this fever is un- 
known. We likewise find that strangers are more liable to be affected 
by this noxious effluvia, and have the disease in a more formidable de- 
gree, than the natives of the country, whose constitutions acquire a cer- 
tain power of resisting it from habitual exposure : at the same time, its 
effects on them are obvious, by shortening the duration of life. I do 
not think that the original disease produced by this miasma is infectious, 
but that it may alter its type and become highly contagious from con- 
current causes ; as from too many diseased bodies being crowded to- 
gether, without paying sufficient attention to ventilation and cleanliness, 
(p. 141.) This noxious exhalation enters the system either by the lungs, 
the skin, or stomach ; but the manner in which it produces those symp- 
toms of disease which characterize the fever does not appear to be well 
understood. We can only perceive its general effects on the system; 
and that it may lurk for a certain time in the habit before morbid move- 
ments take place (ibid). 

iJSff+S 213. In men not below nor above the common standard of health, 
bilious secre- although there were marks of irritation and inflammatory diathesis, it 
gatves P cZ- seemed not sufficient to justify blood-letting; which I considered would 
ry it away. ] iave diminished the vital power. Antimonial emetics were not used, 
having always observed that they increased the irritability of the stom- 
ach, which is the most troublesome symptom attending this form of the 
fever. I, therefore, thought it more advisable to employ mercurial pur- 
gatives, which had a very good effect in carrying off the bilious sordes 
collected in the first passages / emetics were sometimes given ; James' 
powder with camphor, to promote perspiration, and effect a complete re- 
mission (p. 143). 

-S!m«2! ^^' Dy sen t er y- This disease is not limited or peculiar to any cli- 
and wet ob- mate, nor is there any natural cause known to produce it : if it were oc- 
peKplration 6 casioned by any particular quality in the air, the natives, as well as sea- 
fng d tbTflow inen an d soldiers, would be attacked with it, but we find this is not the 



of fluids to 
the intes 



case. For, when the dysentery was raffing anions; the British troops at 
tines. the Cape of Good Hope, not one of the inhabitants were seized with it, 

nor is it a disease known among them. Whenever it becomes epidemic 
among the inhabitants of any country, it may always be traced to infec- 
tion -introduced ; it being the constant attendant on camps, and the 
The cure scourge of an army more destructive than any other enemy. I, there- 
^l on el b y G Th'e lore, consider it an artificial disease. Cold and dampness, when the 
mouth and "b dy is not sufficiently covered, by obstructing perspiration, and increas- 



anus. 



THE DOCTRINE OF PURGATION. 51 

ing the determination of the fluids to the intestines, sometimes combined 
with febrile miasma, produce the whole phenomena of dysentery. In 
the treatment of this disease, I generally began with an emetic of ipecac- 
uanha ; bleeding was never employed, unless the patient was of a strong 
plethoric habit ; purges of salts or rhubarb with calomel were frequently 
repeated ; emollient injections and fomentations were of use, when the 
pains were wandering, and large blisters in every instance removed the 
pain where it was fixed (p. 237). 

215. Diarrhoea generally arose from relaxation brought on by eating J ,iorr ^a 
unripe fruits, and committing other irregularities. It was easily re- cu? e U s! sai 
moved by lenient purgatives (ibid). 

216. Hepatic complaints were brought on by violent exercise in the 

sun, joined to the abuse of spirits. Symptoms: pain in the side, some Liver Com- 
difficulty in respiration, pulse full and frequent, sometimes pain in the p cSfby 
shoulder, and about the region of the liver, which, when pressed, was at- ™ acuation > 
tended with a catching and troublesome cough. Bleeding, calomel 
purges, a blister to the side, sometimes mercury in small doses, were 
alternately resorted to, until health was perfectly restored (ibid). 

217. Spasmodic affections were mostly confined to the abdominal Cramp of 
viscera, and brought on by lying on the deck in the night. The patients the sirTng h ' 
complained of excruciating pain and stricture, commonly about the um- ^med the 
bilical region, nausea, and sometimes vomiting. If fomentations did not 

cure the pain, a large blister was applied ; calomel with jalap taken in- 
ternally and clysters given, until stools were procured, which removed 
the complaint (p. 23S). 

Huggast, A., M. D., On the Croup, Plymouth, 1799. See Med. & 
Phts. Jottrn. 1800 Vol. III. 

218. In a manuscript copy of the late Dr. Gregorys Lectured, I found Croup. 
a caution respecting bleeding in children, even with leeches, as apt to 
bring on fits. Now, if the learned professor's admonition was the re- 
sult of experience — and a case which I myself once saw, leaves me little ,#JJJ 
room to doubt it — what have we not to dread from taking blood away vr ous to 
in a large stream from infants? (p. 57.) . . . With regard to blood-let- altogether an 
ting in general, as a means of cure in inflammation, synocha, <&c, let me 2S^25& 
ask, whence the necessity of diminishing the quantity of blood in such Ynnumma in 
diseases? or what proof have we that the quantity of blood being increas- t'on as wen 
ed, — allowing, however, that it actually is so, — is the increase of it the & * intyphua - 
cause of evil f By taking blood away we undoubtedly lessen the quan- 
tity of it, but do vie really diminish the bulk of the circulating fluids, 

find contract the size of the bloodvessels? This is but doubtful; for, it is 
more than probable that from the loss of blood the secretions are dimin- i a ?E?2So- 
ished, and absorption of moisture from the atmosphere increased, (p. JS^^gJJJ* 
58.) . . From the prevalence of bleeding in inflammatory diseases, some ojteh sunt 
have, either from prejudice in its favor, or from want of proper discrim- ™s fatal' 
ination, used it copiously in genuine typhus, accompanied, as it some- 
times is, with thoracic pains, dec. The result of such practice will be 
obvious (p. 59). 



52 THE DOCTRINE OF PURGATION. 

Upon the whole I think that I am sufficiently warranted, from experi- 
ence, to draw the following conclusions respecting the use of venesection 
in the practice of medicine, viz. : That it is never necessary, seldom 

SAFE, OFTEN HURTFUL, AND SOMETIMES FATAL (p. 60). 

Miller, E., M. D., On the effects of Abstinence on the approach of 
Acute Diseases. See Medical & Physical Journ. London, 1799, Vol. I. 



Moderate 
habits. of 



ease. 



219. If the art of preserving health and prolonging life chiefly con- 
ufe prevent s j s t in Si frugal and sparing use of stimuli, and adapting them with cau- 

l p^ Q erve tion and skill to the fluctuating circumstances of the vital principle, we 
health. gnall surely And still stronger motives to apply this doctrine at the ap- 

proach and in the treatment of diseases, when noxious powers of such 
preternatural violence invade the body, baffle every remedy, and stimu- 
late it to death. The regulations of this vital principle, here denomina- 
ted excitability, the preservation of it when present, and its restoration 
when deficient, the restraint of the excitement within the bounds of 
moderation, the prohibition of all wasteful and undermining excesses, 
will probably hereafter, at some more enlightened era of medicine, form 
a system of rules for the management of health and the prevention of 
disease, for the enjoyment of sense and the refinement of intellect, which, 
instead of the present feverish dream of human life, will present a con- 
summation of improvement and happiness which we now ascribe to su- 
perior beings (Journ. p. 45). 

220. If I do not mistake, it has been proved, that abstinence will be 
of Ab a S ii n6 aff- often a complete, generally a useful, and almost always a safe means 
Spt8 th^ad- of obviating the approach of acute diseases. And, in a word, if it were 
vance of dis- possible to offer to mankind a maxim of universal application to the 

treatment of incipient fevers, in all their variations and circumstances, I 
should be inclined to hazard the following aphorism : When symptoms 
denoting the approach of acute diseases are discovered, abstain, for a 
proper length of time, from all aliment (ibid). 

In the place of abstinence from all aliment, purgation is the method which experience 
has proved safe and effectual, both as a preventive and cure for acute or chronic or incipient 
affections. Brandreth's Pills and weak oat-meal gruel for a few days will do more good than 
abstaining from food, or half starving for weeks. And purging with these pills never weak- 
ens the vital forces, which cannot be said of the other plan. I think that the starving method 
is next in evil effects to bleeding. One takes the life out, the other prevents its renewal, 
i It is effete matters, impure humors, floating in the blood or settling upon some organ, that 

:\ cause all general or local disease. Purging takes these out, and, being done, the health is 

•aS" often restored at once. If you have poisonous matters about you, get rid of them as soon as 

possible. This is the sensible way. Starving does not get rid of them, it only reduces your 
life, your power to feel, that is all ; places you nearer the grave. While every dose of 
Brandreth's Pills takes the death principle away, and places a greater distance between the 
sick and the grave. 

Nooth, J., M. D., Superintendent- General of the hospitals in British 
America. Letter on the treatment of dysenteries and other autumnal dis- 
eases, to Dr. Mitchell, Quebec y Jan. 24, 1799. See Medical Expository, 
Vol. LL.p. 437, quoted in Med. & Phys. Journ. 1799, Vol. LL 

221. Having seen, in the course of mj practice, a great number of 



THE DOCTRINE OF PURGATION. 53 

dysenteric cases, and having experienced the inefficacy, in general, of the 
usual mode of practice, I was induced to try the effects of the several M 5 y * e !S2! 
purgatives now in use, with the view of ascertaining how far any one JJ^"^ 
was preferable to the others, in the treatment of dysenteric /patients, purgation 
Experience soon taught me that the neutralized tartarit of potass was the cure ' 
the most salutary in its effects ; and of course I have always, since that 
discovery, had recourse to it in dysenteries and other autumnal diseases, 
with the greatest success, both in children and adults (Journ. p. 181). 

Seremshtee, J., 31. D., Cases of Fractured Skull, Wisbeach, 1799. 
See Med. & Phts. Journ. 1800, Vol. III. 



Fractured 
skull. 



222. A boy four years of age had fallen from a height of ten feet 
upon a brick pavement. He vomited soon after he was taken up, and 
complained of a bruise on his head, but seemed otherwise quite well. 
There was a very evident depression of the right temporal bone, and 
fracture* of the right parietal bone. Merely a spirituous embrocation 
and a gentle laxative was given. On the next day the depression was Purganves, 
considerably less. ]\ T o one bad symptom had come on, but as the physic a they°°S>e- a 
had not operated, I ordered an enema, took six ounces of blood from the l'^ e] ° s n ^ 
arm, and ordered a strictly antiphlogistic regimen for three weeks ; in f 0Te ' the 
a few days the depressed bone had risen to its natural situation, and in fomsatS- 
a few weeks every trace of it had disappeared (Journ. p. 28). iSteSS" 

Another boy, nine years of age, fell from a cart-horse upon a stone 
pavement and the wheel of the cart passed over his head. I found the 
whole left side of his head very much flattened, the temporal and great 
part of the parietal bone being very much depressed ; besides, there was 
a fracture of both bones, which crossed the squamose suture. The boy 
was comatose, but roused for a moment when spoken to. His breath- 
ing was laborious, pupils dilated, pulse of natural velocity, but intermit- 
ting. He had vomited several times, had bled much from the nose, and 
likewise from the right ear. Trepanning was proposed, but the parents 
objecting, the antiphlogistic plan was all that was left us. He, accord- 
ingly, was bled and an enema administered. The clyster had not oper- 
ated, neither a purgative given on the second day ; the depression kept 
on lessening, but the boy remained comatose ; another aperient was 
given, and on the third day a purgative enema produced a copious stool ; 
the symptoms abated, and disappeared after a repetition of the enema, 
the bowels now being opened (Journ. pp. 28-29). 

Sutton, T., M. D., Considerations Regarding Pulmonary Consumption. 
London, 1799. See Med. and Phys. Journ., 1801, vol VI. 



223. The first symptoms of disease were in the bowels, and by degrees 
the disorder became a confirmed phthisis pulmonalis. Hence I was led thn pro- 
to suspect the emaciation and debility to be induced by some disease of sympathy 
the abdominal viscera^ which, however, I could not account for in any fl 3£ ft ?t£T 
other way except by supposing the mesenteric glands to be obstructed, & *2S? , fr Si 
as the symptoms led to no suspicions of any other cause or causes that diteaee 
could be considered as adequate to produce such effects. I have seen °/ e !y* me * en ' 
several cases where affections of the bowels preceded the pulmonic symp- 



Cor>fmm>p- 



54 THE DOCTRINE OF PURGATION. 

toms. It is a very common thing for patients, in protracted dysenteries, 
to have pulmonic affections before death/ and it frequently happens that 
diseases of the abdominal viscera are, in their latter stages, accompanied 
by pulmonary consumption. By writers on this disease the " tabes rne- 
senterica" is mentioned as sometimes accompanying it. . . Hence, it ap- 
pears to me that phthisis pulmonalis is caused by a disease in the mesen- 
teric glands, and that the tubercles in the lungs, and some other of its 
symptoms, are excited by sympathy (Journ., pp. 89, 90). 

cie. eme lcs 224. For, an increased action may be produced by exciting an in- 
creased motion in the contiguous parts, which may be effected by the use 
of emetics and purgatives, which promote a greater motion in the intes- 
tinal canal, and, from their contiguity, in all probability, communicate 
some of it to the mesenteric glands (Journ., p. 90). 

White, W., Surg., Remarks on Hydrocephalus Internus. Bath, 1799. 
See Med. and Fhys. Journ., 1800, vol. III. 

nydroce- 225. Case of hydrocephalus given. He took small doses of calomel 

?ii a/ dro l sil combined with digitalis. As purgatives produced no effect in stimula- 
by ting the intestines, clysters were resorted to for that purpose. After a 
fortnight, evident symptoms of amendment took place, and he soon re- 



caused 
an abun- 
dance of 
fluid 
cannot 



remove the 
cause of 



bS covere d (Journ., p. 113). Dr. Whytt, to whom we are greatly indebted 
sorbed. for a very minute description of the symptoms usually attendant on the 
disease, observes : '' The immediate cause of every kind of dropsy is the 
same, viz., such a state of the parts as makes the exhalent arteries throw 
out a greater quantity of fluids than the absorbents can take up." Which 
Purgatives state, from what he afterwards mentions, he evidently considered as con- 
sisting in debility (p. 117). Purging is necessary, not only on account 
of lessening the determination to the head, but particularly as the symp- 
toms, which proceed merely from fullness in the stomach and bowels, 
have been frequently soon removed by evacuating the bowels (p. 119). 

Carson, William, M. D., Letter on the Applicability of Mercurial Prep- 
arations in Children^ Diseases. Birmingham, 1800. See Med. 
and Fhys. Journ., 1800, vol. IV. 

226. For several years I have been dissatisfied with the general and 

indiscriminate use of calomel in the diseases of children y I am not more 

certain of any one fact that pertains to medicine than that I have seen 

many children who have fallen a sacrifice to the improper application of 

Calomel this medicine. Calomel, when mixed with susrar, forms a medicine 

never snie ' ^^ * 

in minute agreeable to the palate of the child ; its exhibition is easy to the mother 
a° poison? 53 or nurse, and it may with safety be given as a purge, when a purge is 
indicated. When given as a purge, its action is confined to the first pas- 
sages ; but when the dose is frequently repeated, either for the purpose of 
obviating habitual costiveness, or with any other intention, it is absorbed 
by the lymphatics, and enters the system, by the action of which it is de- 
composed, . . . and that state of the system produced which is called 
mercurial fever. Although mercury does not appear to have so power- 
ful an action on the salivary glands of children as it has on adults, yet 
I apprehend its general effects upon the system are greater. The mer- 
curial fever in adults soon runs into indirect debility. 



Infantile 
diseases. 



Hydro- 
cephalus is 
rather i?i- 
duced than 



THE DOCTRINE OF PURGATION. 55 

227. The injurious consequences likely to flow to children from the 
high degree of excitation and extreme succeeding debility produced by 
a mercurial course I wish to impress upon your readers. Mercury has 
been erroneously held forth as a specific in hydrocephalus, and is often cured or pre- 
given as a preventive of that fatal malady. Hydrocephalus appears to merturi/. 7 
be the result of debility succeeding too high an action of the vessels of 

the brain. If so, can any medicine more powerfully produce hydro- 
cephalus than mercurial calces? (Journ., p. 411.) 

Chapman, John, Sur., Cases of Injuries of the Head, with Observations. 
Ampthill, 1800. See Med. and Phys. Journ., 1800, vol. III. 

228. The fondness for trepanning, so much inculcated by Mr. Pott, 
and so very anxiously supported by Mr. Benjamin Bell, has justly met 
with two very able antagonists in Mr. John Bell and Mr. Abernethy (p. 
31, Journ). Every man, previous to applying the trepan, ought to ask 
himself for what he is going to trepan ? " To think that a fractured 

skull is a chief cause, or even an absolute sign of danger, is a very erro- i Q injuries 
neous notion ; it is not the damage done to the skull, but the iniurv to °f. the ¥ a ?> 

J ^ * *J *' criiru.r or ic2,l 

the brain, that is the cause of danger; and the fracture of the skull is •operation 
but a faint, uncertain mark of the harm done to the brain " (J. BelVs pQnld* p £ 
Discourses on Wounds of the Mead, p. 137). Again : " There is still S( '^£™to y 
but one motive for applying the trephine, viz., to relieve the brain from purge, sua. 

• n /m • i -t a a\ tnereby de- 

compression' (ibid., p. 144). urmine ^the 

Now, I am speaking of affections of the brain, I cannot forbear ob- 
serving that I have long been dissatisfied with the Edinburgh treatment 
of concussions of the brain, viz., with cordials, wine, and stimulants. 
My ideas on this subject are so exactly consonant to what has been said 
by Mr. Abernethy (Surgical Essays,- vol. Ill, pp. 59, 60), that I shall 
therefore refer my readers to his Essays (Journ., pp. 33, 34). iT. B. 
Abernethy employs purgatives, bleeding, and antiphlogistic regimen. 

Fowle, William, M. D., A Practical Treatise on the Different. Fevers 
of the West Indies, and their Diagnostic Symptoms. london, 1800. 
See Med. and Phys. Journ., 1800, vol. IV. 

229. Very early after my arrival in the country I observed that per- 
sons attacked with fevers, in almost any situation, very generally became Yeiioxofe 
yellow. This soon led me to conceive it merely a concomitant symptom 
and by no means such as could be sufficiently characteristic of any one 



blood from 
the head. 



ver a denom- 
ination 
without par- 
icular mean- 



ease a com- 
monfever. 



fever to give it a particular denomination ; it also led me to discover the ing-the dfe 

cause of the variety of symptoms attributed by different authors to the 

yellow fever, and to account for successful methods of cure which were 

often diametrically opposite to each other. The longer 1 remained in 

the country the more I was convinced of the danger attendant on giving 

a name to one disease from a symptom common to so many (Journ., p. 

355). 

Dr. Fowle divides the fevers of the West Indies according to their 
appearances into intermittents, remittents, ardent fever, and the malig- 
nant or jail fever. 



purges. 



56 THE DOCTRINE OF PURGATION. 

Geoghegajs", Edward, Surg., On Strangulated Hernia. Dublin, 1800. 
See Med. and Phys. Journ., 1800, vol. IV. 

230. Let us for a moment consider the state of the parts : A portion 

of the intestine lies without an aperture, through which it is too large to 

ttdhernia' pass ; the question then arises, what occasions its bulk ? Surely, the 

«*^of*the natlire °f ^ ne part, the touch, and all the circumstances of the case, 

case indicat- clearly evince it to he flatus, and sometimes together with excrement and 

tion™ acua ~ an inflamed intestine, whose functions are so far deranged that it cannot 

act upon its natural contents, so as to move them in their ordinary 

course. . . Nothing can be more obvious than that every effort should 

be made to lessen the bulk of the hernia, and none to push it through 

the ring ; it will pass in of itself after the air has been extracted (Journ., 

p. 318). 

Purging with Brandreth's Pills is what is needed. 

Magennis, J., M. D., On Epilepsy. Birmingham, 1800. See Med. 
and Phys. Journ., 1800, vol. IV. 

Th^ l tl P r S por 231. I observed in these patients, and in most others who have long 
acii th and°S- labored under this untoward disease, a dullness of apprehension, a par- 
testines re- ticular stare and vacuum of countenance, a dilated pupil, and an inabil- 
qmres pow- ^ ^ ^ e -j r i s ^ con tract on the admission of light, accompanied with 
stupor and a general irritability of the muscular liber. This torpor ex- 
tends to the stomach and intestinal canal, as those people subject to the 
disorder usually require the most active cathartics and emetics to excite 
the primas vise into action (Journ., p. 419). 

Reeve, R., Surg., On a Successful Case of Hydrocephalus. See Med. 
and Phys. Journ., 1800, vol. Ill 

232. Hydrocephalus internas. — The author's own child, at the age of 
eight months, in December, 1798, could stand alone, and had every ap- 
pearance of a healthy, forward child. His temper was unusually placid, 
case of and his spirits invariably good. Towards the end of the month he be- 
cephaiis' ' came extremely costive, and though medicine for a time relieved him, 
^ece^uy^oi ne was frequently and violently seized with pain in the abdomen, which 
full, contin- was generally mitigated by a clyster. . . He ceased to grow, except the 
fui ' purga- head, which, towards the end of January, 1799, was perceptibly increased 
ll< intestinai e in size, and his costive n ess was become so obstinate as scarcely to yield 
canal. ^o the most active purgatives. It was this singular state of the alimen- 
tary canal, which had existed upwards of six weeks, that first led me to 
suspect some material derangement in the state of the brain. On the 
12th of February he was convulsed in the night, took antimon tartaris 
in small doses, with little, or no effect, and on the following day castor 
oil, which was repeated a second time, before any motion was produced ; 
the abdomen was very hard, and of an extraordinary size ; the stools of 
a clay color, and of such an adhesive nature that they could not easily 
be separated from his napkins ; his urine high-colored, secreted in large 
quantities, and gave a yellow tinge to his linen. James' powders were 
given, but fever and delirium set in, with a voracious appetite, and all 
the symptoms of hydrocephalus. Calomel given as purgative in the be- 



THE DOCTRINE OF PURGATION. 57 

ginning of March was charged with mercurial friction, but all hope of 
his recovery was lost ; he cried much, had much pain in his bowels, 
which were distended by flatus to an alarming degree, and the only relief 
that could be obtained was by clysters. A blister that was applied to 
the anterior fontanelle was kept open and discharged copiously, and in 
April he commenced slowly to recover. . . Now his bowels "are quite 
restored, and he has left off all medicine (Journ., pp. 61-64). 

Brandretk's Pills could have saved all this pain and suffering. * 

Uxwixs, David, Surg., On Febrifuge Medicines. See Med. and Phys. 
Joubn., 1800, vol. IV. 

233. A derangement of the nervous system, occasioning general de~ Fever, 
bility, is an invariable attendant on fevers of every denomination, and to but H onb vS 
this single cause, debility, are all the symptoms which occur under differ- VER >" °>ie 

, y «/? 9 «yX # cause but 

ent circumstances of constitution, situation, habit, &c, of the patients different 
to be referred ; for, notwithstanding the minute division and extensive t font Jesta ~ 
classification which have been adopted by nosological and systematic ■ 
writers on febrile affections, there appears to be no specific or abstract 
difference in the diseases themselves, the variety of appearance which they 
assume being totally dependent upon the state of the constitution receiv- 
ing the affection. Thus, the same causes operating upon a person of a 
sanguine temperament and plethoric habit will occasion the disease 
which has obtained the appellation of inflammatory fever, with symptoms 
of vascular excitement, which, on a patient of a contrary description, 
will be productive of a typhus or nervous fever (p. 54). 

234. When the quickness, smallness, and irregularity of arterial pul- thf^nSt- 
sation, distressing pains in the head, extreme oppression of the mind, } y attending 

" oJ: -I'li'i j? svmptoin re- 

and other symptoms are present, denoting the highest state ot nervous moved, 
debility, a dose of powdered antimony, in such quantity as to create a sympathy, 6 * 
slight nausea of the stomach, will often reduce the pulse to its proper 
standard, and, by inducing a regularity and due proportion between the eiomach 
action and reaction of the system, will effectually arrest the further pro- 
gress of the disease. 

Woodward, W., Surg., On Infantile Diseases. See Med. & Phys. 
Joubn. 1800, Vol. IV. 

235. There is a liquor in the bowels of infants and many other ani- 
mals, when they are born, which is necessary to be carried off; the medi- infantile 
cine which nature has provided for that purpose is the mother's first *'fii*tSd* 
milk; this, indeed, answers every purpose, and effectually; but we e 'X eh l^ lk 
think some drugs forced down the child's throat will do much better — medicine. 
the composition of which varies, according to the fancy of the good 
woman who presides at the birth. . . . We see that notwithstanding the 

many moving calls of natural instinct in the child to suck the mother's 

\ yet the usual practice is to deny that indulgence till the third day 

after the birth ; by that time, the suppression of the natural evacuations 



by stimula- 
ting the 



58 THE DOCTRINE OF PURGATION, 

of the milk usually brings on a fever, the consequence of which is often 
rai Ivacua- fatal to the mother ', or puts it out of her power to suckle the child at 
*and pre cures S tnat time. The sudden swelling of the breasts, which commonly hap- 
miifc-fever. pens about the third day, is another bad consequence of this delay. 
When the breasts become thus suddenly and greatly distended, a child 
is not only utterly unable to suck, but, by its cries and struggling, fa- 
tigues and heats both itself and the mother ; this is another cause which 
prevents nursing. . . . The gentlemen of the Lying-in-Hospital in Lon- 
don ordered the children to be put to the mother's breast as soon as 
they showed a desire for it, which was generally within ten or twelve 
hours after birth ; this rendered the usual dose of physic unnecessary ; 
the milk-fever was prevented ; the milk flowed gradually and easily 
into the breasts, which before were apparently empty, and things went 
on in the natural way. If a mother is determined not to nurse her own 
infant, she should, for her own sake, suckle it at least three or four 
weeks, and then wean it by degrees from her own breast. In this way 
the more immediate danger arising from repelling the milk is prevented 
(pp. 43-44). 



The vital 236. There is, in truth, a greater luxuriancy of life and health in 
en diiidren n infancy than in any other period of life. Infants, we acknowledge, are 
J^aduits^ 11 more delicately sensible to injury than those in advanced life ; but to 
Bleeding compensate this, their fibres and vessels are more capable of distension, 
riout to J lt, their whole system is more flexible, their fluids are less acrid, and less 
Sl? ation disposed to putrescence ; they bear all evacuations more easily, except 
that of blood / and, which is an important circumstance in their favor, 
they never suffer from the terrors of a distracted imagination. . . . 
Children recover from diseases under such circumstances as are never 
survived by adults ; if they waste more quickly under sickness, their re- 
covery is quick in proportion and more complete than in older people ; 
in short, a physician ought never to despair of a child's life while it con- 
tinues to breathe (p. 43). 



Moore, James, Surg., A case of Synocha, London, 1801. See Med. 
& Phys. Jotjen., 1801, Vol V. 

is a common 237. Synocha, or pure inflammatory fever, is a disease so rare in this 

offigh 0X dl- country that many experienced practitioners have doubted its existence. 

£tion° f and Here follows a case : — The treatment employed during the Ave days he 

longer dura- was under my charge consisted simply of two purgatives, and a draught 

of one-fourth of a grain of tartar emetic, and two drachms of the acetate 

Purgation, ammonia water, which was exhibited regularly every six hours. ( Journ. 

' p.<233.) 

Synocha certainly very much resembles the symptomatic fever at- 
tendant upon phlegmon ; the common ephemera is undoubtedly of the 
same species, and the synocha seems to be precisely the same malady, in 
a more violent degree, and running on for a longer period, (ibid. p. 234.) 



THE DOCTRINE OF PURGATION. 59 

Peicaeds, J., Surg.) On Hydrocephalus, Brentford, 1801. See Med. 
& Phys. Jotjkn., 1S01, Vol. V 



238. Case of a boy, 8 years of age, strong purgatives given : This 
produced very brisk evacuations at each time of repeating it (every other 



Hydro- 
cephalus. 

morning) ; after each repetition, however, he appeared better and more SS& pur- 
gation re- 
stores health 



system. 



lively. The plan was continued for several weeks, during which every 
symptom of the disease gradually subsided, until his pristine state of "and vigor, 
health was completely renewed. (Journ. p. 344.) weakens"the 

Therefore it appears to me, that drastic purgatives, frequently ad- 
ministered, have a much fairer chance of success by increasing very pow- 
erfully the action of the absorbents, while they do not produce that debility 
of the system which is the consequence of mercury (ibid. p. 345). 



Savaeesi, A^toeio, M. D., Physician to the French Army in Egypt, on 
the Cure and Prevention of the Endemic Ophthalmia of that Coun- 
try. Transl. by G. Blane, M. D., London, 1801. -See Med. and 
Puts. Joeex., 1801, vol. VI. 

239. Dr. Savaresi first divides this complaint into the sthenic and 
asthenic ; the one depending on an excess, the other on a defect, of tone, ophthalmia 
The former effects the bulb of the eye ; the latter sometimes the " sar- Heties, 66 
sus," sometimes the "tunica conjunctiva." ffistfemfty 

In the beginning I purge in all the three species, without distinction, u P° n wh j^ 
with an ounce of magnesia vitrolata, otherwise called Epsom salts. The 
sthenic ophthalmia requires very close and strict attention, inasmuch as 
the cure depends on the efficiency of the first remedies. After this, top- 
ical remedies, as emollient colly ria, are employed, and low diet. 

As preventive, he recommends avoiding exposure to the sun with the 
head uncovered, and to the night dew, abstaining from salted food, avoid- 
ing cold after being heated, and attention to the intestinal evacuations 
(Journ., pp. 357-359). 



Taln-sh, "W., Surg., Account of Some Cases of the Plague, which occur- 
red on board of a British ship-ofwar on the coast of Syria. See 
Med. and Phys. Jouen, 1801, vol. V. 

240. Plague. — Mr. Tainsh employed, after removing all clothes 
from the patients, and washing them with soap over the whole body, Plng 
powerful repeated evacuations of the bowels by emetics and laxative clys- £*** 
ters. The sick used to discharge "an enormous quantity of bile, viscid S /"'•» 
sordes, and tough phlegm," and the stools gave the sick evidently much ^ 
relief; when a bitter taste and nausea continued, emetics were repeated, 
which cleared the stomach of a large quantity of disagreeable matter, 
which gave great ease. After thus removing the cause of the disease, a 
strengthening treatment was pursued, and the buboes treated by poul- 
tices (Journ., pp. 539-541). 



Powerful 
and repeat- 



tii >ii removes 



GO 



THE DOCTRINE OE PURGATION. 



Vage, T., M. D., Criticisms on the Treatment of Yenereal Diseases. 
London, 1801. See Med. and Phys. Journ., 1802, vol. VIII. 



Opium re- 
laxes the 
■nervous sys- 
tem, and di- 
minishes 
chyh'fica- 
tion. 



211. Opiates are usually and properly given, in the intention of 
mitigating severe pains in the venereal disease ; but, notwithstanding 
their utility, a free and frequent use of them always induces a relaxation 
of the system, and debilitates the chylific organs, which are primary things 
to guard against in mercurial courses. Although both these effects of 
opium appear to spring from one common source, by producing a ner- 
vous, sedative stupefaction, yet some observation in practice inclined me 
to suppose that ease may be procured without any concomitant debility 
(Journ., p. 8). 



Mercury 

breaks 
down, the 
blood. 



Axiom. 



242. Mercury, however, with all its anti- venereal properties, is natu- 
rally inimical to the nervous system, and exerts its injurious effects, in 
some degree or other, in. the most judicious use of it. When it is ex- 
hibited too copiously, and suddenly, it is apt to produce violent effects, 
as great swelling of the head and tongue, apoplexy, &c, because it breaks 
down the blood before any outlet is prepared for its evacuation. When 
its use is gradual, these effects will be moderate, but they will accumu- 
late in time to considerable injuries of the same nature. The most vio- 
lent and mildest effects of remedies are produced upon the same princi- 
ple, and the former are frequently the only index to explain the latter, 
which would otherwise be too minute for observation (Journ., p. 9). 



The two 

causes of 
mercurial 



Parallel 
between 

lead, and 
mercury. 



24:3. The infirmities which arise from the use of mercury appear to 
originate from two principal sources: one is its dissolution of tJie blood, 
by which a redundance of serum is forced into the interstices of the cel- 
lular substance of the muscular, vascular, and nervous systems ; in con- 
sequence of which the gluten, which gives strength and stability to the 
solids, becomes relaxed, and the different functions of the animal economy 
so debilitated as to be incapable to be properly actuated by the nervous 
influence, while the nervous system itself may remain in a tolerable 
condition. The other source of infirmity, on the contrary, is when the 
nervous system has been left impaired and cannot invigorate these f mic- 
tions, which may not have suffered any considerable detriment. For, it 
is experimentally ascertained, that if the nerves of any part are injured, 
either at their origin or in their course, that part will become propor- 
tionally inert in its office (Journ., p. 9). 

The effects of mercury are somewhat similar to those of lead ; both 
have power to produce paralytic affections ; both, in a weaker degree, 
abate inflammations and mitigate pain ; and the imbecility of both re- 
main after they have been quite expelled from the habit (Journ., p. 10). 



211. In considering the dyspeptic symptoms of this or any other dis- 
Dyspeptic ease, it appears to be generally conceived that the cause of them is the 
fSsynwar weakness of the stomach alone. This opinion has probably led to some 
thy between important mistakes in practice ; for this organ is not less subject to be 
liiVandthe affected by causes, and the condition of parts remote from itself, than it 
wiwu sys- ^ ca p a ])i e f affecting the whole system. Thus an indolence of the in- 



Purgatives 

remove the 

symptoms 

nndtn rigor- 
ate intesti- 
nal- action, 
promoting 
the elabora- 
tion of good 



THE DOCTRINE OF PURGATION. 61 

testines, or a diminution of their action in any part, from the pylorus to 
the rectum, will produce nausea and indigestion, even when the stomach 
itself may be in a good condition; and hence it is that often a cathartic 
will remove these symptoms by giving an additional irritation to the 
obstructed and enervated parts. In general, however, here the stomach 
participates of the mercurial debility, and corroborating aperients be- 
come requisite. In regard to the inertness of the intestinal action, it b i /e ,^ the 
may be further noted that it frequently proceeds from a deficiency of the Hon. 
bile, which a cathartic stimulus is likely to prevent, for undoubtedly this 
secretion depends much upon the proper action of the duodenum. But 
the chief utility of the bile results from its chylific property, which ap- 
pears to consist, in a great measure, of mixing the oily and aqueous 
parts of the aliment, and assimilating them into a uniform liquid. 
This great importance of the hepatic secretion, whenever it appears de- 
fective, demands immediate assistance by active purgative medicine (p. 
172). 

Auld, Isaac, M. D., of Edisto, S. C, Case of Acute Bilious Fever read 
before the Medical Society of South Carolina, 1802. See Med. akd 
Phys. Jouun., 1808, Vol. XIX 

215. Case. — A young man who had spent a month in the country, 

on the morning after his return complained of slight chilliness and a i us U /evYr 

dnllpai?i at the pit of his stomach, which soon after terminated in exces- iow^ S fever) 

sive vomiting, violent fever, and intense pain in his head. These symp- symptoms:' 

toms continued without abatement until about three o'clock in the preceding 

afternoon, when they suffered considerable remission. At this time I f°^ few*' 

saw him. I found that so general a suffusion of bile through the System fUi.^/S: 

o M «/. ,© J t parns in the 

had taken place as to resemble a person laboring under jaundice, with bead and 
the exception of the eyes, which were slightly inflamed. His bowels vomiting, 
were obstinately bound, having been in a state of constipation for the ^ ellowness ' 
two or three previous days. His tongue was moist, the edges inflamed, 
the top white, excepting the middle, down which ran a yellow streak 
(Journ., p. 106). 



Cure : 
Powerful 



216. Treatment. — As his pulse, which was slow and irregular, seemed 
now to forbid the lancet, though there was still some pain in the head, 
and costiveness and debility appeared to be the principal inconveniences 

under which he labored, I contented myself with leaving for him two ^ urg H™ 

n -i -i-i'i •ii» • -i • t removing 

smart purges ot calomel and ."jalap, with directions to take one immedi- the cause, 

ately, and the other in four hours, if the first did not procure eight or mutation of 

ten copious stools. On visiting him again, about nine o'clock, I found anf'fam 

that lie had taken both his purges with the happiest effect ; they were then f ace *> 
operating briskly, and had already produced several large evacuations of 
hard, dark, and very foetid faces. The pain had entirely left his head, 

his pulse had become regular and more full, a gentle moisture had over- Natural 

spread his skin ; his stomach had recovered much of its usual tone, and ^SjjLmor- 

this was accompanied with desire for food. On the next morning he had *>id ejacua- 

left his bed with an assurance that he felt himself quite free from indis- ab«oiuteiy 

position. The discharges from his bowels were still kept up, but had ^w?SttS 

entirely lost their foctor, and appeared to consist chiefly of healthy-look- pu J{j£tawnt 



62 



THE DOCTRINE OF PURGATION. 



ing bile. His skin had become much clearer, as had his urine, which 
before was of a deep bilious hue. 

I suggested the propriety of his taking gentle purgatives for a day or 
two longer ' out this advice, from the comfortable state of his feelings, 
he declined, and I, of course, left him. On the third morning after this 
Awful con- I was sen ^ ^ or "k° attend in all possible haste, as the patient was supposed 
sequences of to be dying. I found him speechless, his jaws were fixed, as also were 
purgat.ln. his eyes, which were nearly closed ; he had no pulse at the wrists, his 
feet, legs, and knees were perfectly cold, and his stools, which were black 
and very offensive, came from him involuntarily ; his breathing had 
been very laborious, but now it appeared to be free from anxiety. I was 
informed that the day I left him the pain in his head and the fever had 
returned with its former violence, and had continued without any dimi- 
nution until this morning, when it terminated in the comatose state de- 
scribed. The cure was hereafter effected by nitric acid and blisters, 
which restored the vitality of the patient, and by a continued applica- 
tion of that acid and strong purgatives, which carried off large masses 
of very foetid, hardened faeces (Journ., pp. 106-109). 



Eruptive 
disease of 
the head. 



Physiology. 



Treatment 
by cleanli- 
ness, with 
spare diet 
and purga- 
tion. 



Badger, John, Surg., On a singidar kind of Eruptive Disease. See 
Med. and Phys. Journ., 1802, Vol. VIII. 

217. The first opportunity of witnessing this disease was at Putney, 
in the month of July, 1801 ; it seemed to be confined to children only 
of a certain age, having never seen a child affected with it before seven 
nor after fifteen years, though equally exposed, as it was evidently infec- 
tious to them. It commences with a slight fever, which continues three 
or four days ; it then increases ; nausea, and sometimes vomiting, attend 
(in one or two instances I have observed the patients to complain of vio- 
lent sickness after they were put to bed), with pain in the head and 
loins ; it is then succeeded by an eruption containing a well-matured 
pus ; the pustules are large and very thick about the head, resembling 
those of small-pox ; and in every case I have seen they have been con- 
fined to the head, particularly to the scalp. The bowels during the pro- 
gress of the disease were unusually constipated, and, in one or two in- 
stances, not only the body but the face likewise was much swelled. The 
first two or three cases I had not an opportunity of seeing till after the 
eruption had taken place to a great extent, covering almost the whole of 
the scalp. 

218. The hair was shaved off as close as possible, tar ointment and 
a mild purgative applied ; but this treatment produced no amendments, 
the ointment rather increasing the number of pustules. I ordered, there- 
fore, the head to be kept clean with warm soap and water, the patient 
to use a spare diet, and the bowels kept open with an active purgative 
once or twice a week, or " pro re nata," and a few drops of antimonial 
wine given once in four or six hours, till the feverish symptoms had sub- 
sided. This plan was pursued for several clays without having at all 
mitigated the complaint, though it seemed, under every circumstance, to 
be the best mode of treatment that could be adopted. Accordingly it 
was continued for a few days longer, at which period the pulse became 
regular, the pain in the head and loins was removed, the pustules began 



THE DOCTRINE OF PURGATION. 63 

to dry off, and in about a week the complaint entirely ceased (Journ., 
pp. 106, 107). 



Cueeie, "William, M. D., Observations on the Treatment of the Malig- 
nant Yellow Fewer which prevailed partially in the City and Liber- 
ties of Philadelphia in the summer and autumn of 1802. Phila- 
delphia, 1802. See Med. and Phts. Journ., 1803, Vol. IX. 

219. Mercury was generally employed both internally and externally 
for the purpose of exciting salivation as speedily as possible, both at the _ Yeiiowfe- 
hospital and in private practice ; but, if I can trust my observations, 
seldom with, success, excepting where employed at the very commence- 
ment of the disease, and so conducted as to affect the mouth before the 
dangerous symptoms of the second stage had time to make their appear- 
ance. 

"When employed in the second stage of the disease, at which time the ■^ t fa t ** 
predominant symptoms are generally disordered stomach, restlessness, op- aisoiJfly 
pression, and deep sighing, and a countenance that denotes great misery, l^'Tecond 
it constantly aggravated the disease, and hurried on the fatal symptoms stage - 
of black vomiting. 

In this stage of the disease, when the recited symptoms predomina- 
ted, the frequent exhibition of mild laxatives in small doses, particularly 
Eochelle salts, soda phosphorata, soluble tartar, castor oil, senna, and aSfJSJJSSJJ 
cream of tartar, and when these could not be obtained, laxatives and drinlT ' 



ter 



Mercury 
seldom use- 



re- 
in ore the 
worst symp' 
toms. 



clysters, were the most successful remedies, especially when aided by 
blisters to the stomach, wrists and ankles, at the same time. 

A solution of carbonate of soda in water, which is much more pal- 
atable than the vegetable alkali, followed immediately by a tablespoon- 
ful of diluted lemon juice, or cream of tartar in water, had also some- 
times the effect of allaying the distressing propensity to puke. But 
these, as well as every other means that I have seen tried, too frequently 
failed of affording relief (pp. 98, 99 Journ.) 



[If mild laxatives were frequently apt to allay the worst symptoms, 
it is reasonable to expect complete success from active purges J] 



250. In this state of the stomach the internal use of mercury, either 
alone or when combined with opium, always increased the distressing andTpium 
propensity to puke ; and, when it failed to operate by stool, it aggravated 
every symptom of the disease (Journ., p. 100). 



aggravate 
the symp- 



251. In cases where the disease began with strong action of tlie arte- 
ries, severe pain in the head, bach and limbs, with little or no sickness at Active 
stomach, bleeding, purging with active medicines, and the strict observ- ^JjJjJJid 
ance of every part of the antiphlogistic regimen, generally occasioned with de P le 
a partial solution of the fever on the third, and a complete solution on 
the fifth, day from the attack (Journ., p. 101). 



tion cures. 



64 THE DOCTRINE OF PURGATION. 

Heberde^, "William, M. D., Commentaries on the History and Cure 
of Diseases. London, 1802. 

252. A diarrhoea arises from a variety of causes, most of which are 
void of all danger, and are easily removed. It is often Drought on by that 
marrhaa, I ower which is exerted in every part of the body of freeing itself from 
Nature'sWy anything painful and oppressive. Not only the mischief from the nox- 
ious qualities and improper quantities of what has been taken, and im- 
mediately offends the stomach, are carried off by means of a diarrhoea, 
but likewise many disorders of remote parts or of the whole body are, 
by the self correcting powers of an animal body, determined to the bowels, 
and thence discharged by diarrhoea. It is frequently useful to cooperate 
with nature in promoting this evacuation. (Chap. XX VII.) (Cf. Coll. 
136, 143 ; Pringle, 200.) 



of cure. 



Co-operate 
with nature. 



ters 



253. Dysentery. — The usual methods of treating this malady, with 
Dysentery which I was acquainted, of ten failed of procuring ease, and of preventing 

by remov T its ending fatally. It appeared that in a dysentery some hurtful humors 
ufic n mat- hud been deposited in the intestines, which threw them into such disor- 
derly agitation as to hinder the expulsion of what had offended them 

Purgatives were administered with the double good effect, both of afford- 
ing present ease, and afterwards of entirely removing, by effectual evac- 
uations, the cause of the disorder. (Chap. XXXI.) 

254. Icterus (Jaundice). — Good effects may with reason be expected 
from purging medicines, by their increasing the natural motions of the 

jaimdice. intestines and soliciting a greater flow of bile as well as of all the other 

Avoid mer- humors which are poured into them. Mercurial purges have been pre- 

iSe'otherand fer^ed by some practitioners, but there appears 7iothing in the known 

safe purga- powers of mercury peadiarly useful in dislodging a biliary concretion, 

and the preference should be given to those purges wich act with the most 

ease, and may be continued with the greatest safety. (Chap. L.) (Cf. 254.) 



Colic. 



255. Ileus (Colic). — The peculiar and distinguishing symptom 
which characterizes the inflammatory colic in the very beginning is cos- 
Purgatives tiveness, which it is always extremely difficult, and too often impossible, 
eure - to conquer. As soon as a discharge downwards can be . procured in a 
e a ua copi 0113 manner, the patient perceives a quick abatement of all his mis- 
uons must ery, and is often restored to health. But it is not from one or two small 
u\d™nd n ~co- evacuations that we can entertain much hope of the distemper beginning 
P m!ert°cov- *° E^ ve wa y- This has happened on the first or second day, from the 
ery- excrement which was lodged in or near the rectum, far below the seat 
of mischief. And later in the distemper, a very small portion of that 
liquid matter with which the bowels are deluged has seemed to have 
been forced downwards, while the disease was every hour growing 
worse. Such inefficacious evacutions have been observed more than 
once or twice in the course of this illness, without saving the patient's 
life Warm baths, fomentations, &c, are serviceable helps in dis- 
posing the bowels to yield to the power of cathartic medicines, by the fail- 
ure or sticcess of ivhich the life or death of the patient must at last be 
determined. (Chap. LI.) (Cf. Hipp. 12, 38, 41, 45, 57. Parep, 85, 87.) 



THE DOCTRINE OF PURGATION. 65 

* Tyeo. — On Apoplexy. See Med. & Phts. Jo urn., 1802. Vol. 
YIII. {Controversy between Mr. Crowfoot and Dr. Lang slow on the 
question whether emetics or bleeding be applicable in apoplexy f 

256. In addition to the testimonies adduced by Pyrrho (one of the 
writers participating in the controversy), I shall only add, that Baglivi, Apopievv. 
who divides apoplexy into sanguineous and pituitous, observes : f™\^'{!^ 1 - 
" Arcanum in sanguineis est phlebotomia. In pituitosis contra emeti- eia by pur- 
cum, aid pur gains vehimens. Sunt qui apoplexia (pituistosa scilicet) lib- wmuing\ 
erati sunt, hausto singulis mensibus vomitivo ex infuso prsedicto (inrus. p^mmT 
croc, metal cum vino)." a . . . .Aretaeus does not recommend emetics, but 
observes : " if the sacred purge should excite vomiting, it is not to be 
restrained, because it evacuates pituita, the cause of the disease, and 

rouses the patient by imparting a degree of vigor." Bairhaave, among 
the general evacuants to be used in this disease, mentions vomits and 
strong purges*, though he adds, there is something uncertain in their 
action. Vanswieten, also, in his Commentaries upon this Aphorism 
(1026), observes, that emetics ought not to be condemned in this dis- 
ease, and are often useful, because they evacuate pituita ; though he 
afterwards thinks purgatives less objectionable. (Journ., pp. 6&-69.) 

Baedsley, Samuel Aegent, M. D., Physician to the Manchester In- 
firmary, Dispensary and Lunatic Hospital. An Account of the 
Epidemic Catarrhal Fever or Influenza in Manchester, dec. See 
Med. akd Phys. Jouen., 1803, Vol. IX. 

257. Emetics were found highly beneficial on the first attack ; in- 
deed, the frequent occurrence of spontaneous nausea and sickness pointed infiuenm, 
out their use. They scarcely ever failed to relieve the urgent symptoms ff 
of pain in the head and stricture of the breast. To obviate costiveness 
and at the same time to cleanse the primse vise, moderate doses of calo- symptoms 
mel, with rhubarb and antimonial powders combined, were exhibited with 
excellent effects. . . Opiates were seldom employed during the first stage them - 
of the disorder, as they had a tendency to exasperate the complaints of 
the head and chest, and increase restlessness and feverish heat (Journ., 

pp. 525, 526). 

Kexglake, TtosERT, M. D., On Influenza. Bee Med. and Phys. Jouen., 
1803, Vol. IX. 

258. My experience authorizes me to say that the benefit of abstract- 
ing heat, by atmospheric exposure, light bed-clothes, copious dilution 

with cold water, and avoiding stimulants of every description, will pShgSia 

almost certainly rescue the patient from danger, and leave nothing mor< 

for medicine to do than gently to move the bowels in case of costiveness, w^^ 

and, at most, to aid the refrigerant plan by the milder sudorifics (Journ 

p. 520). 



Evacuation 
atomacJi 
and bowels 
reli"ve the 



Opium in- 
creast 



the o n 1 1/ 

medicine re- 



a In the sanguineous, phlebotomy is the arcanum. In the pituitous, on the contrary, 
emetics or strong jmrgativex. Some people remain free from apoplexy by taking every month 
a draught of aforesaid vomitive infusions. (Inf. croc, metal, c. vino.) 



66 



THE DOCTRINE OF PURGATION. 



The re/rig- 
erativaplan 
contended 
for. 



259. It is an erroneous notion that occasional refrigeration and ab- 
stinence in disease weaken more than a heating and stimulating treat- 
ment. The native energy of healthy power is certainly reduced both 
by the abstraction and increase of excitement, but by its due diminution 
vital force may be said to be nursed, while undue stimulant agency tends 
to dissipate it even to extinction ; hence a moderate negation of excite- 
ment debilitates much less directly than its excessive employ does indi- 
rectly (Journ., pp. 519, 520; Eemark). 

Our method for the cure of Influenza is to purge very freely with Bran dreth's Pills, six 
pills every twelve hours the first day. Keeping in bed as much as possible ; oatmeal gruel 
or light broth ; if the head is very painful, feet in hot water with mustard or wood ashes; 
if throat is sore, gargle with weak alum-water ; outward applications are the Allcock Plas- 
ter, mustard poultice, red pepper, or any stimulating liniment. When the skin of the 
throat becomes a little red, the outward applications dispensed with. Should a choking 
sensation be felt, or the breathing- be difficult, four Brandreth's Pills must be taken every 
four hours, or even oftener, until relief is experienced. 



Yellow fe- 
ver. 



Its com- 
mencement, 
symptoms 
and general 
course. 



Anomalies 
and sudden 
changes. 



Thefavor- 
able symp- 
toms. 



O'Berne, P., Surg., Observations on the Fevers in Hot Climates. Lon- 
don, 1803. See Med. and Phys. Journ., 1803, Vol. X. 

260. The more severe in symptoms, and dangerous in effect, any dis- 
ease is, the more necessary the investigation of, and researches after, 
methods of cure must be fully impressive on every mind ; it is scarcely 
necessary to add that perhaps none comes more strongly under this de- 
scription than that generally termed yellow fever / none, therefore, more 
interesting claims our attention. 

In the commencement, generally nausea, pain in the head, loins and 
hams, succeed ; dry surface, increased pulse, but not to be depended on, 
varying from 80 to 140, chills, anxiety, sighing, prostration of strength ; 
vomiting soon takes place, and not unfrequently is the first indication of 
the disease. The vessels of the tunica conjunctiva become turgid, and 
a yellow tinge of that membrane takes place, frequently extending over 
the body. Notwithstanding this circumstance gives rise to the name 
usually given this complaint, it is by no means a constant attendant, and 
in many totally wanting. Watchfulness and desire to sleep, without 
being able to effect it ; whilst in others constant dozing, pain and sensa- 
tion of heat in the stomach, great thirst ; vomited matter gradually 
changes from yellow to dark green, and at length perfect black. Clammy 
skin, sometimes petechia, but unfrequent ; stupor or violent delirium 
succeed ; paroxysms of vomiting become more rapid, and many expire in 
one of those paroxysms too shocking to describe, whilst others placidly 
resign exhausted nature (Journ., pp. 36, 37). 

261. No disease perhaps exhibits a greater variety of symptoms, and 
often less to be depended on, than this ; sometimes it goes on with every 
favorable appearance, suddenly changes to the worst, and patients, ap- 
parently almost in a state of convalescence, expire in an hour or two. 
This is a melancholy fact (Journ., p. 37). 

262. The symptoms that we may call favorable are, settled state of 
the stomach, lessened headache, eyes lively, formation of pustules over 
the surface, or that eruption known in tropical climes by the name of 
prickly heat, I have ever remarked as almost a certain indication of re- 
covery ; bilious flux, copious and high-colored urine, free perspiration, 
and sound sleep (ibid.) 



The dan- 
gerous 



THE DOCTRINE OE PURGATION. 67 

263. The dangerous, and, I am sorry to add, most common, symp- 
toms, are severe headache, frequent vomiting, heat increasing to a burn- 
ing sensation, extending down the trachea and alimentary canal ; matter symptoms. 
vomited and faeces becoming dark, frequent sighing, dull or glassy eye, 

pale and little mine, dark fur on the tongue, muscular and nervous de- 
bility, intermittent pulse, clammy feet, cold sweats, stupor or violent 
delirium, singultus, coma (ibid.) 

264. That dark matter vomited, termed hlach vomit, it may be neces- 
sary to remark, although laid down by most authorities as a certain fatal 

sign, is by no means so, as I have seen many recover after it; it is also The Mack 
said " that a diarrhoea almost precludes any hopes of recovery." If by X d7arrhTa 
diarrhoea is understood a simple {or bilious) flux, I have ever observed it / u °tli AT sy m L . 
a decided fortunate event; certainly a flux of putrid dark fasces is ex- toms - 
tremely bad, and yet even that I have many times seen prove salutary 
(ibid.) 

26'5. Out first and principal attention should be directed to clearing 
the first passages, and to keep them free during the disease being of the 
greatest importance. M en£ 

Emetics are by many laid entirely aside, on the principle of increas- 
ing the already irritable state of the stomach. That a great deal of ig the 
caution and discrimination in their use is extremely necessary must be purgation 
allowed ; but I am decidedly of opinion much benefit is to be obtained 
by them. Where nausea or slight vomiting occurs, ipecacuanha is the 
best ; but if the vomiting be more severe, an infusion of chamomile will caution, 
answer every intention. 

Cathartics. — Calomel, combined with powder of jalap, is perhaps one 
of the best ; the irritating quality of the neutral salts seldom makes 
them advisable. 

266. Blood-letting has been advised by some of the most respectable Bleeding 

authorities ; I shall therefore only observe that I never saw it used with ItlVyThwt- 

advantage ; on the contrary, I always thought it of disservice (Journ., fuI - 
p. 38). 



The TREAT- 



AT ALL 

EVENTS ; 

emetics ad- 
missible with 



In the sec- 
ond stage, 



267. Our next intentions must be directed towards lessening the 
irritable state of the stomach, supporting the strength, and resisting that 
tendency to putrescency that exists in this disorder. pSS <he 

Notwithstanding the great variety of opinions that have been, and aJ^JJJSJ^ 
still are, on this subject, calomel will still perhaps be found the most muetbekept 
successful medicine hitherto employed, and, in general, I have but little f™* tantl/y 
doubt its want of success in many instances may be attributed to the 
manner of giving it, or want of attention to the state of the bowels. Cal- 
omel if not given in large quantities quickly repeated had better not be 
given at all. 1 have used from live to eight grains every two hours, and 
sometimes every hour, combined with three grains of the antimonial 
powder, until a diaphoresis was induced, when the latter was omitted, 
and the calomel continued until the effect was evident, as metallic taste, 
foetid breath, or sore mouth. When a gentle salivation is raised, desist 



68 



THE DOCTRINE OF PURGATION. 



Enemas. 



Opium 
and bark 
useless. 



in frequency, yet continue so as to keep up the effect of the mercury ; 
the criterion of its success may be determined by its action or non-action. 
"When a speedy and copious salivation comes on, the most happy effects 
may be looked for ; while the contrary prove the reverse. And here 
again let me observe that the most minute attention must he paid to keep 
the bowels free, for which purpose enemas are the best (Journ., pp. 
38, 39). 

268. Blisters, although uncertain, are of great utility both in pre- 
venting delirium and lessening vomiting, applied to the region of the 
stomach. General warm bath is of the utmost service, or, where that 
cannot be conveniently had, washing all over with warm water (Journ., 
p. 39). 

269. Of all remedies in use for this disease, excepting calomel, per- 
haps none are of more real service than enemas, and the more simple the 
better — such as warm water, oil and vinegar ; but on the increased vas- 
cular action and heat subsiding, enemas composed of orchis, sago, or 
portable broth ; this last I have found of such uncommon service as 
makes me wish most strongly to impress the use of it ; in many cases, 
where animation seemed nearly exhausted, recovery was the unexpected 
and welcome effect of this salutary practice (ibid.) 

270. Opium I have found of little, if any, service, in any stage. 
Cinchona appears to me evidently of disservice until the patient fs 

in a convalescent state (ibid.) 

Brandreth's Pills are in every respect superior to calomel as a purge, and they leave no 
evil after effects. 

Potter, Nathaniel, M. D. Letter on the Epidemic Distempers of the 



Measles. 
Purging 
actively em- 
ployed cures 
and pre- 
vents bad 
conse- 
quences. 



year 1802. 
vol. XL. 



Baltimore, 1803. See Med. and Phys. Journ., 1S04, 



271. The cure of measles this year may be almost reduced to two 
simple remedies, blood-letting and purging. For, when these were used 
in time, and carried to a sufficient extent, little or nothing remained to 
be done. These remedies were no less efficacious in removing the im- 
mediate symptoms than in removing the consequences of the disease. 
This will be sufficiently apparent when we enumerate the deplorable 
train of consequences that followed their neglect (Journ., 7, 312). 



272. Purging was a very useful remedy, and required to be repeated 
p every second day, or oftener, as there was a constant reaccumulation of 

curTby % mr- that green and acrid matter that was sometimes ejected from the stom- 

thQ l7 lno°rbid ach on the first attack ; and this disposition commonly lasted four or 

matter. £ ve <jays. Where purging was neglected in the commencement, the 

evacuations from the intestines were often of a dark green, brown or 

black complexion, just as it happens in other malignant fevers (Journ., 

p. 313V 

273. Antim,onials were certainly improper remedies in this disease ; 
they depressed the pulse, and seemed to act too much like the causes of 
the disease. Are not antimonials equally unfit remedies in all malignant 



THE DOCTRINE OF PURGATION. 



69 



fevers, where the tendency to indirect debility is great, and more espe- 
cially in those called contagions, where the " vis nocens " is so prone to 
induce the same state of the system ? 

Blisters were equally inapplicable in the first state of the disease, 
but co-operate powerfully with emetics in arresting the progress of indi- 
rect debility in the advanced state of measles, and sometimes called 
forth dormant excitement to great advantage. 



Antimo- 
nials alto- 
gether inju- 
rious; blis- 
ters and > •pi- 
ate* applica- 
ble only con- 
ditionally. 



Opium was also inadmissible in all its forms, unless toward the latter 
state, when fever did not contraindicate its prescription for the cough, 
which was often the last troublesome symptom, and seemingly occa- 
sioned by the action of a small portion of the pulmonary vessels (Journ. 
p. 314.) 



Power, George, Surg., Assistant Surgeon to the Twenty-third Regiment 
of Foot, Royal Welsh Fusileers. Attempt to investigate the cause of 
the Egyptian Ophthalmia, dec. See Med. and Phys. Journ., 1803, 
vol. IX 



274. The next local cause of Ophthalmia in Egypt is the custom of 
sleeping at night in the open air, imbibing with every inspiration, and 
absorbing at every pore, the putrid virus contained in the descending 
dews. . . . Thus in a system peculiarly debilitated, and unable to resist 
all its powers combined, it produces that highly putrid fever called 
plague. In a patient less relaxed, as the habit of the body determines 
the disease either to the surface of the skin or to the intestines, an erup- 
tive fever or dysentery is produced ; and when the putrid virus is but 
partially applied, to the eyes for instance, or to the month, or even on 
the surface of the body, ophthalmia, ulcerated fauces, or ichorous blotches 
on the skin ensue (Journ., p. 78). 



Ophthal- 
mia. 
Influence of 
n i uTi t-dew 
in hot cli- 
mates pro- 
ducing differ- 
ent diseases, 
according to 
predisposi- 
tion. 



275. As the author freqently refers to a treatise of the French Sur- 
geon Bruant, it will be of interest to know what this writer says on the 
cure : " This disease is frequently cured by the simple operation of na- 
ture, and without any assistance from art ; and indeed we may affirm 
with truth that nothing so much opposes the cure as too great a profusion 
of remedies, especially topical. Some patients have been relieved by an 
eruption coming on at the temples ; others, and the greater number, by 
a slight diarrhoea ; and hence, to act conformably to the views of nature, 
I have encouraged a discharge from the bowels during the whole dura- 
tion of the disease, by employing tamarinds or other laxative titans 
(Desgenettes Histoire Medicale de l'armee de l'Orient. — Journ. p. 580). 



Nature in- 
dicates the 

cure by 
evacuation. 



Wadley, T. "W., Surg., on the Prevailing Epidemic Influenza. Stow on 
the Wold 1803. See Med. and Phys. Journ., 1803, vol. IX. 

276. First, the exhibition of an emetic was always promised, which 
seldom failed of evacuating the stomach of a dark colored, greenish, and 
most offensive fluid. Aperients were always rejected when given before 



Hon of fetid 

dark- color- 
ed excre- 
ments 



70 THE DOCTRINE OF PURGATION. 

irlmuwms an eme ^ c j an ^ an enema was found of no service. The pain in the 

(iccumuia-^ 'head was constantly lessened and frequently removed by the vomit, and 

a freer expectoration sometimes relieved the cough. When costiveness 

was a very urgent symptom an active purgative was given, which never 

cure by failed of being followed by stools of a peculiar footor and black color, 

?he cause. and this state of the alvine discharge often accompanied the disease 

throughout (Journ. p. 516). 

Medicus, Practical Observations on the Treatment of the Scarlet Fever 
and Bore Throat. Bee Med. and Phys. Journ., 1804, vol. XII. 

277. It is well known that many pass very safely through the scarlet 
ve™ r wLn fever, in its mild state, with little or no medical assistance. But when 
quires' Tut m tna ^ s * a te medicines are administered, I fear the cure is, by the inge- 
nttie medical nious theoretical practitioner, ascribed too often to their effects and not 

to the mildness of the disease, especially if some fashionable medicine 
has been prescribed. Hence remedies undeservedly creep into prac- 
tice, and, I fear, in serious cases frequently supersede the use of those 
which have long stood the test of sound practical experience. 
The cause I pretend not to account for the source or origin of the scarlet fever 
~mntui d \xi an ^ sore throat, but am well satisfied that the " fomes morbi " of the 
the bowel*— disease, however generated, lurk in the bowels. Under this conviction 
"moved 6 by 6 I enjoin them to be well cleared, in whatever stage or however violent the 
purgatives. di sease ma y oe ^ w hen I first see the patient, if I suspect that such necessary 
treatment has not been before observed. The very f ootid smell of the 
evacuation, and the relief such evacuation immediately procures, strongly 
prove to me the necessity of purgatives, and I may add, from reiterated 
observations, that the longer they are delayed the more severe proves 
BHsh^r- the disease. Many practitioners, alarmed at apparent debility, are de- 
not hurt, but terred from exhibiting brisk cathartics lest their operation should irre- 
^thevUai* coverably sink the patient. Such apprehensions would be justly 
power. founded if purgatives were administered without due discriminating 

attention to age, constitution, and immediate state of the patient. But 
where such attention is paid, I have never seen any mischief arise; on 
the contrary, the most salutary effects have taken place merely from 
the bowels being relieved from the contained accumulated foetid foeces, 
and hence every febrile symptom becomes milder, and the vital powers 
invigorated, not debilitated (Journ., pp. 25, 26). 

Patterson, W., M. D., Case of Brainular Affection from an Internal 
Cause. londonderry, 1804. Bee Med. and Phys. Journ., 1804, 
Vol XII. 

278. A gentleman, aged above sixty years, was suddenly attacked 
Apoplexy, with a severe pain in his forehead, accompanied with so much megrim 

e ?- & Ti efa- an0 ^ stomach sickness as would have caused him to fall had he not re- 

touscharac- ceived support \ to these symptoms was added coldness. He was put to 

Ur ' bed; blood-letting pretty ' largely in the arm; purging, and blistering 

the back, legs and head, in succession, were employed. Four days after 

the seizure, when I was called, I found him in bed complaining grievously 



THE DOCTRINE OF PURGATION., 71 

of a violent pain in the forehead, together with an irksome stricture in the 

eyeballs and surrounding teguments. The functions of the brain were gSrgtg^ 

impaired by a degree of stupor, attended frequently with incoherent diving the 

mutterings. His pulse was unequal, laboring, and accelerated with a tMeactS 

tenseness in the vessel ; the temporal arteries throbbed considerably, but if^S&b- 

were uniform in their action. The countenance was sometimes pale, r iu > } \? f 

-,-,.-, ^ t . rv. n . i t -I . i -i circulation. 

sometimes reddish, and at other times surrased with a bluish tinge ; the 
eyes were languid, and the sense of vision much diminished, at periods 
almost lost. The temperature of the skin was sometimes pretty high, 
more frequently below the medium warmth, and generally felt languid 
and flaccid. There was sometimes an urgent thirst, but for solids little 
or no appetite. His stomach, indeed, continued to have a loathing, and 
so retrograde a disposition as to approach vomiting, which he himself 
considered to proceed from vitiated bile. His bowels were sluggish, and 
had not emptied themselves since the operation of the laxative medicine, 
which was a space of thirty-six hours before I saw him. He was rest- 
less, and when he seemed to sleep it was a morbid comatose state rather 
than a salutary repose. The organs of respiration did not appear par- 
ticularly engaged, and the urinary organs were equally unaffected. 

From the preceding phenomena I concluded that there existed a de- 
termination of blood to the head, with increased tension of the arteries 
of the part. Under this impression, I ordered local evacuations, by 
means of numerous leeches to the temples, and a brisk cathartic to excite 
and empty the bowels, as well as to promote an equilibrium in the gen- 
eral circulation. The first application of leeches procured a sensible 
relief, and therefore it was repeated. The cathartic was not active enough 
in its operation, and accordingly a stronger one, composed of calomel and 
aloes, was given, and with manifest advantage. The stupor in a short 
time decreased, and was succeeded by a loud talkative raving, accom- 
panied with unconsciousness of persons and things around him, of which 
inattentive state a remnant continued for several days. The delirious 
condition lasted for some hours, and was followed by a profound sleep, 
attended with a stertor resembling that of apoplexy, but distinguishable 
from it by softness and equable movement in the pulse. This change 
was the harbinger of convalescence, which gradually but slowly took 
place. 

Considering the phenomena of this case, I am led to conceive that 
we would be justifiable in setting it down as a decided instance of apo- 
plexy ; but certainly it was rather of an anomalous description, as it 
assumed many of the features of a species of erysipelas which takes 
place in the membranes and vessels of the brain in the evening of life 
(Journ., pp. 109-111). 



Pearson, A., Surg., in the service of the East India Company. Some 
Observations on the Pathology and Prevailing Diseases of Warm 
Climates. London. 1804. See Med. and Puys. Journ., 1804, Vol. 
XL 

279. On Acclimation. — In the first change from a cold to a hot cli- 
mate it was formerly the practice to bleed indiscriminately ; It is now per 



72 THE DOCTRINE OF PURGATION. 

haps too generally omitted, as it might be often employed to obviate or 
issa}!lst and remove disease arising from inflammatory congestion. Purging has also 
Ti^vrefen- heen recommended for universal adoption • and when we reflect that the 
live of eii- constitution both admits and requires this evacuation more frequently in 
easesf ** warm than in cold climates, and bears it better, its utility will be found 
as probable as experience proves it to be. The neutral salts have been 
generally prescribed, and these are certainly of the most universal appli- 
cation and use ; but vegetable purgatives will be best for frequent use. 
(Inf. sennse et temarind, p. rhei. et kali tartar, separately or combined ; 
of the former 3j. to § i-, and § j.to J ii. of the latter.) Occasionally four 
or five grains of calomel may be taken with much advantage, from its 
effect in stimulating the mucous or biliary excretories, when some of the 
laxatives above specified ought to be given next morning. The day on 
which any of these remedies are given ought to be one of peculiar mod- 
eration, and dilution with barley-water or rice gruel attended to. 

"With regard to the use of tonics, or antiseptics, the indications for 
Deuuty employing them, and their utility, are much less than is generally sup- 
farity^S posed. The feeling of debility is often fallacious, and produced by the 
cretion. organs being overloaded, or a biliary absorption (Journ., pp. 161, 162). 

280. In the warm climates the attacks of febrile disease are gener- 
ic™ ^J accompanied with symptoms of bilious absorption, and torpor oft/ie 

The symp- intestinal canal, and with a greater or less tendency to remission. The 
cate pw-ga- treatment recommended by authors is very contradictory ; some advising 
g\nni f ng mbe " a continued and severe evacuant plan, while others administer bark on 
every appearance of remission, and even without waiting for it. If 
purging with calomel and neutral salts is assiduously practiced in the 
first days, giving intermediately mild diaphoretic and antimonial medi- 
cine, the use of bark will be found unnecessary (Journ., p. 201). 

281. I am doubtful if the genuine remittent fever appears without a 
Miasmata previous exposure to the exhalation of marshes, or that from rank vege- 

^dhowS-V? Nation ; and the distinct remissions and exacerbations described in books 

act upon the are not frequently to be met with. . . It is frequently some time after 

prSng the the application of the remote causes before the disease comes on. . . The 

"S3o? d debilitating effect of the marsh-miasmata is generally recognized, and it 

activity. is probable that the nervous energy and muscular irritability are much 

and suddenly impaired by their impression upon the sensorium ; the 

powers of circulating the mass of blood are for a time diminished ; from 

that, irregular actions of the vessels of different viscera, a relative degree 

of plethora and inflammation takes place, while, from the excretories 

being similarly affected, the power which the economy possesses to rid 

itself of an excess of heat is abated. In such a state it is not surprising 

that congestions should take place in the brain and glandular viscera 

(Journ., pp. 201, 202). 

Bennion, Thomas, Surg., on the Gibraltar Fever. Gibraltar, 1805. See 
Med. and Phys. Journ., 1805, vol. XIV. 

ramffel'er 282. In the first the patient is seized, without any previous notice, 
a species of with giddiness, pain of the head, slight sickness at stomach, darting 
Ing oTthe pains from the head to the back, and spasmodic affections of the calves 
pui a gue, ter y ei f of the legs. The breathing was very hot, incessant sighing, the greatest 
t^hul eraud dejection of spirits. The tongue was in the beginning white; a bad 



THE DOCTRINE OF PURGATION. 



73 



taste was complained of; the sense of smelling was imperfect or de- 
praved ; the visage extremely distressed, and unwillingness to speak. 
The countenance on the first attack became suddenly sallow ; in a very 
short time, however, it became red, full and bloated, with the exact ap- 
pearances of intoxication. Drowsiness and sleep followed in a few hours, 
when a little moisture came out on the skin. This appearance, however, 
at this stage was delusive ; it suddenly left the patient, and was succeeded 
by the most intense heat, that gave a smarting sensation to the fingers 
when applied to the skin. There was at this time a most uncommon and 
offensive smell from the whole body. The eyes were now much inflamed; 
there was violent pain in the temples and over the arches of the eye- 
brows, darting to the orbits. The pulse from first to last was greatly 
increased, but never so strong and firm as in inflammatory diseases ; the 
thirst less than generally in acute diseases. There was strong pulsation 
in the carotid arteries, and an evident enlargement of the jugular vein. 
The color of the skin approximated that of the lilac, cocklicoque, violet 
or poppy, and changed as the disease advanced to a deep yellow. By 
the early administration of strong emetics and purgatives on the first 
attack, the yellowness seldom appeared, and every other had symptom was 
averted (Journ., pp. 137-138). 

283. When these had not been exhibited, and in cases where the dis- 
ease from first appeared in a more aggravated form, the second set of 
symptoms soon appeared ; the patient was very comatose, much tremor 
of the limbs, frequently an incessant vomiting of black matter, with 
convulsive hiccough ; the eyes were drawn in a direction alternately from 
the nose to the temples in a frightful manner, with nearly total blind- 
ness. The skin was now parched with burning heat, or covered with a 
clammy offensive sweat. The body was covered with petechias and 
vibices, swellings appeared in the armpits and groins, often degenerating 
into abscesses ; foul gangrenous sores on the back, and carbuncles on 
different parts of the body. There were hemorrhages from the nose, 
ears, mouth, and pores of the body, with every appearance of a total 
dissolution of the blood-vessels. Then the fasces and urine were passed 
involuntarily, and the other usual symptoms indicated speedy dissolu- 
tion (Journ., p. 138). 

284. My first step was invariably to put the patient into a warm 
bath, then to rub the body well with soaped flannel, and put him to bed. 
If the powers of life were strong a solution of tartar emetic and glauber 
salts was given, which generally operated smartly both on stomach and 
bowels, so that I frequently had little more to do but remove the debil- 
ity, the patients being often well on the third day. If the solution, per- 
severed in, did not operate, the stomach arid bowels being very insensible, 
I gave calomel either alone or combined with jalap and the compound 
extract of colocynth. I endeavored by all means to keep up the divine 
discharge ; when obtained, the patient was perfectly relieved and free 
from fever ; if not, the fourth or fifth day put an end to all enquiry. 

After procuring evacuation, I prescribed saline medicines, when 
little fever remained ; but when the disease continued after the third 
day, it turned out to be the severest typhus. Opium or bark did not 
succeed ; when liberally given, I perceived them evidently doing mischief 
(Journ., p. 139). 



Symptoms 
of the first 
stage avert- 
ed by emet- 
ics and 
strong 
purges. 



The symp- 
toms of the 
second stage 

and the 
close. 



The treat- 
ment by full 
evacuation 
of stomach 

and bowels. 



n 



THE DOCTRINE OF PURGATION. 



Dysentery. 
Enemas of 
emetic sub- 
stances. 

Also in 
piles and in- 
flammation 
of the rec- 
tum, &c. 



The man- 
ner how they 
operate. 



They in- 
crease the 
secretion of 
mucous and 
carry it off 
per (mum, 
without pro- 
ducing' vom- 
iting, and re- 
move the in- 
flammation 
from the in- 
testinal ca- 
nal and rec- 
tum. 



Their ap- 
plication. 



Clark, Thomas, Surg., Observations on the Nature and Cure of Fevers 
and Diseases of the West and East Indies, and of America, <&c. 
Edinburgh, 1805. See Med. and Phys. Jottrn., 1806, Vol. XV. 

2S5. Dysentery. — Having, in violent cases, often found the remedies 
now described, or any others that I had tried, ineffectual, I at last had 
recourse to the use of emetic substances in the way of injections. I did 
not adopt these, however, till I had reflected very seriously and reasoned 
very fully on the subject. The other remedies already mentioned, except 
injections, were administered at the same time. From much experience 
I do not hesitate to assert that they have been, and, I believe I may 
venture to say, will be, found extremely beneficial in dysentery. It ap- 
pears to me more than probable that they will also prove useful in cases 
of piles, and, in short, in all Jcinds of inflammation affecting the rectum 
and parts adjoining. When given early in the disease they generally 
afford immediate relief, and sometimes one or two injections effect a cure. 
When they have not been used until the advanced stages the patients 
experience more uneasiness from them, particularly on their first being 
thrown up ; but if they can be prevailed upon to keep them for a min- 
ute or two, the uneasiness in a great measure ceases, and they are often 
able to retain them for a considerable length of time. The manner in 
which these injections operate is for the most part as follows : 

In the incipient stages of the disease, even when attended with vio- 
lent pain and tenesmus, and all the more violent symptoms of this dis- 
ease, immediate relief is almost constantly experienced from them ; and 
they are commonly retained for a considerable length of time with little 
or no uneasiness. At length an effort to go to stool comes on, and several 
copious natural evacuations, mixed with mucous, are procured ; and in 
the more violent cases several evacuations of slime, or mucous alone, or 
intermixed with blood, succeed to the natural stools, accompanied with 
little or no straining. After this, the patient commonly remains for a 
number of hours without any symptoms of disease, and in some in- 
stances it does not return. 

Those injections do not appear to occasion vomiting, or even to in- 
crease the irritability of stomach that may have previously existed. 
They probably assist in increasing perspiration, however. I do not 
believe that they operate very powerfully in that way ; at least, in some 
cases, I have found it impossible to produce a copious perspiration by 
ipecacuanha, both in the form of injection, and also at the same time 
given by the mouth, in considerable quantities. 

The salutary effects of these injections appear to me to depend chiefly 
upon their exciting a copious secretion of mucous from the internal coat 
of the great guts, and thereby removing the inflammation affecting 
them. 

I have known a few ounces of this injection give immediate and 
permanent relief in several instances of very painful inflammatory affec- 
tions about the extremity of the rectum ; a copious secretion of mucous, 
resembling the white of eggs, being produced. 

I generally have given two, and sometimes three, in the course of 
twenty-four hours. The best general rule, I believe, is to administer 
injections whenever the more violent symptoms of dysentery return, or 
threaten to do so. 



THE DOCTRINE OF PURGATION. 75 

Strangury, which frequently accompanies violent cases of dysentery, 
■will be found very seldom troublesome when these injections are used ; rf47velTby 
the reason why it is not so must appear obvious to every one. 1 ! lis iD J ec - 

The form of injection which I have found to answer best has been 
about three drachms of ipecacuanha root, bruised, and boiled down in a Thepre- 
quart of water to one pint, and given at dnce as a clyster. From ten to the enem °* 
twenty grains of tartar emetic, dissolved in a pint of warm water, will 
produce nearly similar effects (Journ., pp. 85-87). 

Dysentery and Diarrhoea. — These affections of the bowels are Nature's efforts to expel 
diseased matters from the blood, and must never be suppressed ; but nature must be assisted 
bv a free use of Erandreth's Pills, which are absolutely certain to cure if used before the 
powers of life are exhausted. 

Dr. Clark's method is vastly superior to opium or any of the astringent remedies so 
readily prescribed by the generality of medical men. But Brandreth's Pills are certain and 
commit no mistakes. If convenient, an ejection of pure water, about summer heat, will be 
found to comfort the bowels, but the cure depends upon purging the humors from the blood. 

Hamilton, James, M. J)., Physician to the Royal Infirmary and various 
Hospitals in Edinburgh. Observations on the Utility and Admin- 
istration of Pxirgative Medicines in Various Diseases. Edinburgh, 
1805, 8th edit., 1833. 

2^6. The history of medicine clearly shows that theory or reasoning 
has contributed in no small degree to impede its progress. EE SS7 

Let it be our endeavor, by circumspect induction from facts, to estab- ^f s ' AD - 
lish sound principles which may lead to the discovery of other facts, and medicine. 
these again to the introduction of more general doctrines, or a compre 
hensive and connected theory of medicine (p. 21). 



TJie colon. 



2 ; 7. The nutritious part of our food is prepared and separated by T he mode 
the changes which it undergoes in the mouth, oesophagus, stomach, and, of ^r/^»- 
with the assistance of fluids secreted from the liver,- pancreas, and spleen, of the etom- 
is perfected in the smaller intestines ; while the lacteal vessels, opening Sines! 1 m * 
on their internal surface, absorb and convey the nutrimental fluid into 
the circulating system. The residue of the food, which is not adapted 
to afford nourishment, constitutes part of the fecal evacuation which is 
made directly from the intestinal canal (p. 21). 

288. This fecal residue is discharged into the more capacious colon, 
where the ilium enters it by a lateral opening, so contrived that the 
contents of the colon cannot be returned. This circumstance makes a 
distinction between the functions of the smaller and larger intestines, The big and 
which is not commonly noticed. The former complete the preparation J™^ 1 int * 8 - 
of the nourishment, and afford opportunity of its being absorbed; while 

the latter receive and detain the fecal part till after it has accumulated, 
and, perhaps, undergone certain changes, when it is voided in a given 
quantity and at stated intervals (p. 22). 

289. Besides, the intestines exhale and throve off fluids which have BouoU 
become noxious in consequence of changes which they undergo in the function of 
body. The intestinal canal, therefore, serves the double purpose^ the tiu D e3 ? 9 " 
repairing waste and of preventing decay. In this latter function, which 

I am solely to consider, the intestines co-operate with the other secretory 



Vicarious 
function of 



Pretention 
of fecal 
matter 
causes dis- 
ease ; regu 



76 THE DOCTRINE OF PURGATION. 

organs, the skin, the lungs and kidney. All these organs have, in re- 
spect of this their common relation to the system, a dependence upon one 

organs. another, and any of them will compensate, to a certain extent and for a 
limited time, the interrupted action of the others. Nevertheless, their full 
activity is necessary to the enjoyment of perfect health, and the contin- 
uance of life ; and the regularity of the intestinal evacuation is connected 
in a particular manner with the well-being and healthy state of the 
stomach and intestines themselves. The urine and perspirable matter 
pass off immediately after being secreted, and do not load the organs 

la,- diges- wn ich separate them. The unnatural detention of these excretions has 

lion neces- . , -, L n i n n t tv i i 

sary for indeed a more or less remote, and often fatal, enect upon the general 
heam. B j S t em? "but the skin and the kidney remain uninjured. It is otherwise 
with the intestines : secluded from that communication with the atmos- 
phere by which the perspirable matter is carried off, and unprovided 
with an appendage resembling the urinary bladder connected with the 
kidneys, they are the reservoirs of fecal matter as it is poured out, which 
they retain till the accustomed period of evacuation comes round. Dif- 
ferent circumstances are apt to induce irregularity in this evacuation ; 
. these, together with the facility with which the larger intestines admit 
of distension without uneasiness being excited, give frequent oppor- 
tunity for a progressive accumulation of faeces, whence arise interrupted 
action of the stomach and smaller intestines, and consequent dangerous 
and fatal ailments (p. 22). 

Evacua- 290. In infancy, the alvine evacuation is frequent, and the faeces are 
Set** - a abundant and fluid. In mature years the body is generally moved once 
pearance in twenty-four hours, and the faeces, although soft, preserve a form too 
* of either 6 well known to require description ; they are of a yellow color, and they 
rangemen?of em ^ a peculiar odor. When, therefore, the faeces are evacuated less 
the bowels, frequently than the age of a person demands ; when they are indurated ; 
when they change their natural color and odor, derangement of the 
stomach and bowels is indicated, and the approach of disease, if dis- 
ease be not already formed, is to be apprehended. For it is not to be 
imagined that organs of so great importance in the animal economy as 
the stomach and bowels are, can be long in a state of inaction, and the 
general health remain unimpaired (p. 23). 

291. The propulsion of the contents of the intestines is effected by 
Peristal- means of a vermicular, or, as it has been called, a peristaltic motion of 
the' bow- the bowels from above downwards ; hence torpor, or loss of tone in the 
muscular coat of the intestines, by which this motion is thought to be 
co'Ztipa J -^ interrupted, is understood to be the cause of much distress, and tonic or 
stimulant medicines are employed to remedy this torpid state. I use 
this language, and speak of torpor of the bowels, although my ideas 
producing respecting it do not correspond with those of others. I am inclined to 



tic viotion 
of 

els, if inter- 
rupted by 
constipa- 
tion, causes 
excrementi 
tious a ecu 
■inula tit. 



,li 



its cure by think that the symptoms referred to loss of tone proceed, in many 
purgation. occas i o;ns? m0 re directly from the impeded peristaltic motion, the conse- 
quence of constipation. In this situation we may easily understand 
that the distended colon cannot, for want of space, receive the contents 
of the smaller intestines, which will of course stagnate throughout the 
whole canal ; the action of which being thus interrupted, will soon alto- 
gether cease, and be at last inverted. The various ailments which 



THE DOCTRINE OE PURGATION. 



77 



thence ensue, are daily before onr eyes ; and the relief which, under 
these circumstances, we observe to follow soon after the exhibition of a 
purgative, and the cessation of complaint which takes place upon its 
operating freely by stool, are in proof that this opinion is well founded. 
If, again, we farther consider that the greater part of the exhalations 
made into the cavity of the intestines is excrementitious, and will, if re- 
tained, beyond the usual period, undergo changes and acquire injurious 
acrimony : and if, moreover, we advert to the sympathy which many of 
the organs of the complicated animal frame have with the stomach and 
intestines, we cannot but recognize the great influence which these must 
possess over the comfort, the health, and the life of the individual 
(p. 24). 



292. These are weighty considerations, and ought to excite our 
attention to any irregularity of the divine evacuation. The necessity of 
this will farther appear when we reflect that many circumstances, unavoid- 
able in social life, expose mankind in a peculiar manner to constipation ; 
such as improper food, intemperance, sedentary occupations in confined 
or otherwise tainted air. Besides, in a therapeutic view, we are encour- 
aged to exercise this attention. It is admitted that diaphoretic and 
diuretic medicines employed to remedy interrupted secretion by the 
skin and kidney, operate circuitously, often possess deleterious qualities, 
or are uncertain and irregular in their effects ; while the means of re- 
moving constipation act directly on the seat of disease, are safe, and 
seldom disappoint us in the attainment of our object (p. 25). 



Constipa- 
tion — its 
causes 



Constant 
attention to 
the state of 
the diges- 
tio7i recom- 
mendable. 



293. In the dawn of physic, purgatives were employed. But, 
although they have been recommended by the earlier as well as by later 
writers, and although the indications they are meant to fulfill have been 
an object of attention to the practitioners in all ages, yet I do not think 
that the extent of their utility has been always clearly perceived, or that 
their administration has been always properly directed (p. 27). 



The pur- 
gative meth- 
od, however 
ancient, not 
sufficiently 
appreci- 
ated. 



294. Another objection to the use of purgatives is urged with a force 
that seems to carry conviction along with it. It is observed that the 
constant application of stimulating articles creates a habit not only of 
using them, but entails also the necessity of occasionally increasing their 
stimulating power. Habit or custom will indeed reconcile us to the im- 
pression produced by unusual stimuli, and will counteract their effect in 
such a manner, that if the stimulus be suddenly withdrawn, or, which 
is the same thing, be not gradually increased, the functions of the organ 
to which it had been applied will become languid and irregular. This 
law of the economy no doubt extends to the promiscuous use of purga- 
tives given unnecessarily during the enjoyment of perfect health. In 
many instances, however, of disease, constipation and accumulation of 
faeces demand this stimulus to restore the healthy state of the intestines, 
and to promote the expulsion of their indurated contents. In propor- 
tion as these objects are accomplished, the stimulus from the same pur- 
gative becomes more and more powerful ; and so little is the necessity 
for continuing it, or for increasing its dose, that, on the contrary, were 



How to 
regulate the 

application 
of purgative 
medicines. 



Purgation 

KEMOVES 

bility. 



78 THE DOCTRINE OF PURGATION. 

not the activity of the purgative diminished, or were it not withdrawn 
altogether, as convalescence advances, we should be in danger of in- 
ducing weakness by an excess of purging (p. 29). (Cf. Hipp. 16.) 

295. Purgative medicines, properly administered, will not induce 
at debility J on the contrary, the bowels being excited to propel their con- 
tents, their functions are restored, appetite and digestion improved, and 
the patient, so far from being weakened, is nourished, supported, and 
strengthened. (29.) 

296. Purgative medicines have also been thought unnecessary on 
this account, that in many diseases little food is taken ; and, therefore, 
regular alvine evacuations are neither requisite nor to be expected. The 

mentitfous residue of food unfit for the purpose of nutrition contributes, no doubt, its 

a ton7are" share of feculent matter / yet the abundant secretion from different or- 

P without 9 an s, an d the exhalation of excrementilious fluids made into the cavity 

Tf h ' foo fC- °f ^ e intestines, constitute the bulk of the fceces collected within them. 

& uon P fasti So long, therefore, as fluid is supplied, and so long as the circulation. is 

fied ' supported, it is equally easy to understand how faeces are produced, 

independently of much solid food, as to perceive the necessity of their 

daily evacuation during the course of fever, and of other diseases of 

long continuance (p. 30). 

297. I refer the superior utility of purgative medicines in typhus 
fever to the circumstance of their operating throughout the whole extent 

fever Vhm of the intestinal canal, the healthy functions of which are essential to 
Purgation t j ie recovery, in a manner that is consonant to the course of nature, by 

cures, ana •/ " . 5 J 

why conso- propelling its contents from above downwards, and to their moving and 
SurL ° na ~ completely evacuating the feculent matter, which in this case becomes 
offensive and irritating (p. 35). 



How excre- 



298. More extended experience confirmed these conjectures ; and I 
was gradually encouraged to give purgative medicines during the course 
mug to end. f typhus from the commencement to the termination of the disease 
(ibid.) 



Purgation 
from b-g^n 



Full pur 



beneficial 



299. I have directed a strict attention to this practice for a long 

time, and I am now thoroughly persuaded that the full and regular 

L" evacuation of the bowels relieves the oppression of the stomach, cleans the 



loaded and parched tongue, and mitigates thirst, restlessness, and heat of 
surface, and that thus the later and more formidable impression on the 
nervous system is prevented, recovery more certainly and speedily pro- 
moted, and the danger of relapsing into fever much diminished (ibid.) 

Purgation 300. For many years past I have found wine to be less necessary (in 
s £ per irfre- typhus fever) than I formerly thought. . . This chiefly attributed to the 
moving ae- purgative medicines which I employed with freedom, obviating and re- 
moving symptoms of debility. This doctrine is at variance with that 



bility 



THE DOCTRINE OF PURGATION. 



79 



which is commonly entertained, but I am confident it is consonant to the 
fact (p. 36). 



301. The complete and regular evacuation of the bowels, in the course SSg * 

needful in 
Jever\ 



of fever, is the object to be obtained (ibid.) 



302. The early exhibition of purgatives relieves the first symptoms, g,nhm V ln 
prevents the accession of more formidable ones, and thus cut's short the axiQm - 
disease (p. 37). 



303. I had learned that the symptoms of debility which take place in Purgation 
typhus fever, so far from being increased, were obviously relieved by the JJ^fJi %- 
evacuation of the bowels. I have never in scarlatina, in a long course of ***•; euws 
experience, witnessed sickness and fainting, which some authors have so ver, and 
much dreaded ; neither have I observed revulsion from the surface of 
the body and premature fading, or, in common language, " striking in" 
of the efflorescence, to follow the exhibition of purgatives (p. 45). 

Accordingly no variety of the disease has hitherto prevented me 
from following out this practice to the extent which I have found neces- 
sary (p. 46). 



causes no 
striking in. 



304. Purgative medicines are useful in removing dropsical swellings D^rmsicai 

the consequence of scarlatina, when the weakness of the patient is often steeling 

very great. Purgatives also afford a means of preventing this swelling, aKemoved 
and other derangements of health (ibid.) 



by purga- 
tion. 



305. When I consider the languor and lassitude which precede mar- 
asmus, instead of adopting the common opinion of its being occasioned 
by worms, I am more disposed to think that a torpid state, or weakened 
action of the alimentary canal, is the immediate cause of the disease. 
From this proceed costiveness, distention of the bowels, and a peculiar 
irritation, the consequence of remora of the fazces; and I have accord- 
ingly been long in the habit of employing purgative medicines for the 
cure of marasmus ', the object is to remove indurated and foetid faeces, 
the accumulation perhaps of months, and as this object is accomplishing, 
the gradual return of appetite and vigor mark the progress of recov- 
ery (p. 59). 



Marasmus 
from torpid 
bowels, con- 
sequent, dis- 
eases and 
their cure by 
purgatives. 



Purging 
the, -first step 
to be taken. 



306. Epilepsy, than which no disease is so afflicting to the patient, is Epilepsy. 
frequently the effect of particular irritation of the mind or body. Prac- 
titioners enumerate worms in the intestines, or marasmus, among the 
causes of epilepsy. Surely this will induce us, on the first attack of epi- 
lepsy in children, arising from an uncertain cause, to set on foot the 'moist 
decided and active course of purgative medicines, lest we perad venture 
allow the disease to strike root, while we are idly employed in the exhi- 
bition of inert and useless vermifuge medicines, or are groping in the 
dark in quest of other causes of the disease, or of uncertain remedies 
for their removal (pp. 63, 64). 



Chlorosis 
Fearful re- 



80 THE DOCTRINE OF PURGATION. 

307. Chlorosis. — The slightest attention to the history of the disease 
evinces that costiveness precedes and accompanies the other symptoms. 
Costiveness induces the feculent odor of the breath, disordered stomach, 

uufts of cos- loss of appetite, and impaired digestion. These preclude a sufficient 
supply of nourishment at a period of growth when it is most wanted ; 
hence paleness, laxity, flaccidity, the nervous symptoms, wasting of the 
muscular flesh, languor, debility, the retention of the menses, the suspen- 
sion of other secretions, serous effusions, dropsy, and death (p. 71). 

308. The greater capacity of the female pelvis gives more room for 
that part of the intestinal canal which is contained within it to dilate, 



require full and, of course, to admit of greater accumulation of feadent matter, which, 
more a iu&n in proportion to its remora, becomes more and more abundant, and more 
men. impacted. Hence costiveness is more obstinate, and chlorosis and other 

dise isei originating in costiveness, are more severe and are of more diffi- 
cult cure in the female than the male (p. 72). 

to escape ^09. Great attention and assiduity is requisite in the exhibition of 

failure purgative medicines in chlorosis, and the frequency of its repetition must 

fylid'/Zr- be varied according to circumstances, which can only be ascertained by 

ussiy. £| ie i nS p ec tl on qf the " al/vine egesta" The practitioner who is not aware 

in pect °*' ^" S > an( ^ who, yielding to the importunity of his patients, or the 

the stools, caprice of their relations, does not steadily pursue his plan of cure, will 

be disappointed, his abilities will be called in question, and his practice 

vilified and neglected (p. 73). 



and 



310. The symptoms (of hysteria) undoubtedly denote a preternatural 
d^aSTus affection of the stomach and alimentary canal. In my opinion they 

S m™ved mS b re a ff° r d conclusive evidence that this affection is primary, and that the 

purgation, other multifarious symptoms of hysteria depend upon it (p. 87). The 
first purgatives that we use may seem on some occasions to aggravate 

g ative pi irri- * ne symptoms, but the practice must not be deserted on that account. 

tation soon The additional irritation which purgatives may give in the first instance 
soon passes away, and perseverance in the use of them removes that irrita- 
tion which gave rise to the disease, which, of course, disappears in pro- 
portion as me bowels are relieved of the oppressive mass of accumulated 
faeces (p. 88). 

311. St. Vitus' Dance. — Powerful purgatives must be given in suc- 
cessive doses, in such manner that the latter doses may support the effect 

st ntus' qf the former, till the movement and expulsion of the accumulated mat- 
Let the ter are effected, when symptoms of returning health appear. Whoever 
Tronfhiuld undertakes the cure of chorea by purgative medicines must be decided 
smiiT doses an( ^ nnn t° ms P ur P ose - The confidence which he assumes is necessary 
dangerous, to carry home to the friends of the patient conviction of ultimate suc- 
Sperseve- cess. Their prejudices will otherwise throw insurmountable obstacles in 
eSSSuL** hi s wa ,7- Half measures in instances of this kind will prove unsuccess- 
ful, and were it not for perseverance in unloading the alimentary canal, 
the disease would be prolonged, would place the patient in danger, and 
thus bring into discredit a practice which promises certain safety (p. 97). 



of medical 
practice." 



THE DOCTRINE OF PURGATION. 81 

312. The agonizing spasms, the prominent symptoms of tetanus, have 
arrested the notice of every one. To resolve the spasm and to cure the caSST" 
disease have been conceived to be one and the same thinq. Accordingly, „ cur . e . d b ^ 
opium, musk, warm bathing, cold bathing, and mercury, have been em- modic3," 
ployed in tetanus. But have they mitigated the severity of tetanus or Md 7 Juu 
obviated its fatal tendency ? " The records of physic bear a sad testi- ww* 10 "- 
mouv in the negative." "However just these observations may be, I 
should yet have been sorry to have advanced anything to shake the tot- 
tering fabric of medical practice in tetanus unless I thought it had been 

in my power to substitute one more efficacious, originating in other t^"^^^ 
views of the disease. These views, I apprehend, will warrant the expec 
tation of considerable benefit from the full and free exhibition of pur g a 
tive medicines (pp. 107, 108). 

313. Under the impression which I entertain of the utility of pur- irydro- 
gative medicines, and of the inefficiency of the tonic plan of treatment p Ant£>as- 
in tetanus, no doubt remains with me respecting the mode of attempt- SJmoiS" 
ing the cure of hydrophobia, which has hardly in any instance yielded 

to the most powerful antispasmodics. Purgatives are proposed to remove 
a cause which frequently induces, and which may always aggravate 
spasmodic affections (p. 123). 

314. Palpitation of the heart merits particular notice in this place. 

I have witnessed the efficacy of purgative medicines in the most forbid- Paipita- 
ding and apparently desperate instances of the ailment, in so much, hea"rt.° f The 
that I am not now disposed to despair of any case, till 1 am satisfied JJJJj 
that purgative medicines have been fully employed, and employed in 
vain (p. 122). 

315. I am persuaded that the preservation of regularity in the alvine 
evacuation, will at all times prevent the accession of those diseases (pre- ^VI™^ 
viously enumerated). If these expectations be not too sanguine, it is 4 classks: 
likely that the marasmus and chlorosis, the vomiting of blood, chorea, bowels reg^ 
and hysteria, of which I have spoken, will rarely, if ever, appear. It prJSA^S 
is fitting, therefore, that this observation should be widely spread, that ft«ns of da- 
it should be conveyed to mothers and nurses, to superintendents of nur- 
series, of manufactories, and of boarding-schools, and to all instructors 

and protectors of children and young people, and strongly impressed on 
their minds, by such of their medical advisers as think with me, and 
who will acknowledge that to prevent disease is the paramount duty 
(p. 125). (Cf. Sanctorius, Aph. 1., Sect. I.) 

316. The practice which leads to this conclusion (the free use of pur- 
gatives in the case of diseases), is presented in a simple form. It is nei- ga uve plan 
ther disguised by hypothesis, nor obscured by the simultaneous employ- {jjf^JJ^i 
ment of various remedies. At the same time it is supported by proofs ^fiaga- 
of unquestionable authenticity, which are not surpassed by any in the 
records of medicine. On these accounts, the truth or fallacy of my 
opinions may be easily investigated, and an adequate judgment of them 



cased 
cured. 



82 



THE DOCTRINE OF PURGATION. 



readily formed (p. 114). Here follow upwards of fifty cases of cure in 
various diseases, extracted from the records of the Royal Infirmary. 



Chronic 
diseases re- 
quire the 
fullest pur- 
gation. 



Half meas- 
ures bring 
discredit on 
the cause. 



31 7. The steady exhibition of purgative, medicines is absolutely nec- 
essary to the success of the practice in chronic diseases. The puny state 
of the sufferer may on some occasions excite alarm in the breast of the 
practitioner. ; and -the caprice of his patient, and the whims of relatives, 
may oppose obstacles to his conducting the cure in the most advantage- 
ous manner. But these he must disregard ; for unless he can suppress 
his own improper feelings, and overcome the unreasonable objections of 
others, he had better not adopt measures which, to prove successful, must 
be conducted with firmness. A contrary conduct will necessarily term- 
inate in the vexation of the practitioners, in the disappointment of the 
patient and of his relatives, and in the discredit of that practice which 
it has been my wish and study to recommend (pp. 124, 125). 



Location 
determines 
the nature of 
the disease. 



318. Diseased actions depend on the nature of the impressions, the 
parts on which they are made, and on the constitution of the patient. 
The same impression applied to different parts of the body may produce 
different actions ; cold to the extremities producing chilblains, or gan- 
grene ; to the head catarrh ; to the chest cough or pleurisy (p. 125). 



Facts alone 
establish re- 
liable sci- 
ence. 



Practical 
experience 
must super- 
sede theoret- 
ical schemes, 
and simple 
remedies the 
rubbish of 
the materia 
medica. 



319. To conclude, the reader must have observed the beneficial 
effects of purgative medicines, in diseases apparently different, and inci- 
dent to people at various periods of life. The facts are undeniable, and 
serve to prove the extent and importance of the subject ; but of these I 
do not feel it to be incumbent on me to give any explanation at present. 
Such an attempt might be premature. I am satisfied to have established 
certain leading facts, and to have opened views which, if properly pros- 
ecuted, must give an opportunity to extend our knowledge respecting 
the utility and administration of purgative medicines. It will then be 
time to generalize the facts, and to form a system of medical doctrines 
at once clear and comprehensive, and thence to deduce practical pre- 
cepts useful in proportion as they will be simple and precise. When 

THESE EXPECTATIONS ARE FULFILLED, OUR POSTERITY MAY SEE DECEPTIVE 
REASONING, HOW INGENIOUS SOEVER, BANISHED FROM THE SCHOOLS OF 
MEDICINE, AND FROM THE PRACTICE OF THE HEALING ART A MULTIFARIOUS 
PRESCRIPTION OF INERT AND NAUSEOUS MEDICLNES (pp. 125, 126). 



IMPOKTAJSTT SEKIES. 



McMullin, Joan, M. D., On the treatment of Chorea Sti. Viti, by 
purgatives. See Edinb. Med. and Surg. Journ., 1805, Vol. I. 



plan 
ure. 



320. Many diseases of symptomatic debility, which have resisted the 
The ton'c use of tonics, have either been considered as incurable, or our failure 
has been ascribed, not to our pursuing an erroneous method of treat- 
ment, but to our means having been too feeble, or employed too late ; 
and obstinately persisting in the tonic plan, on each succeeding occasion, 



THE DOCTRINE OF PURGATION. 83 

we push it with greater vigor and with the same want of success. There 
are, however, fortunately, practitioners who act more philosophically, and 

regarding with distrust theories which do not stand the test of experi- 
ence, endeavour to advance the science of medicine by the slow hut sure 
method of observation and induction. It is in this way that we some- 
times find a disease yielding to a plan of treatment diametrically oppo- 
site to that which the established opinions concerning its nature would 
have suggested (p. 25). 

321. With the view of alleviating the sufferings of those laboring st , 
under similar complaints, and of correcting the erroneous ideas enter- dance. 
tained of the nature of the disease, I am induced to publish some 
observations which occurred to me in consequence of having witnessed 

the cure of some cases of Chwea Sancti Viti in the Royal Infirmary of 

this place (Edinburgh). In these cases, a mode of treatment was adopted cure by 

which no opinion of the disease hitherto published seemed to authorize ; f a a tk^f— r ' 

although in every instance it was attended with the most marked advan- ^jJZ not 

5_. . & . .. „ , , 7 . . debilitate, 

tages. 1 his treatment consisted m the repeated frequent exfnoition of &*** 
drastic purgatives, which will appear on perusing the following cases stren ° thm - 
not to have had the effect of debilitating still more an apparently debili- 
tated system ; but on the contrary, during their employment the patient 
recovered strength, the involuntary motions gradually abated, and by 
persisting in this treatment for a short time, a perfect cure was effected. 
What is particularly worthy of observation, is the appearance of the di- 
vine discharges, which in every instance was black and fetid (p. 26). 
Here follow five cases. 

322. From these cases, the following facts seem to be established : General 

1. From the exhibition of even two or three cathartics, the involun- advantages 

77,7 from purga- 

tary motions and other symptoms were muck abated. Hon. 

2. Although the cathartics tvere continued daily for a considerable 
length of time, the patient, instead of becoming more debilitated, became 
stronger and walked with a firmer pace. 

3. During the progress of the cure, if at any time the cathartics did 
not produce an evacuation, the involuntary motions recurred, and all 
the symptoms were aggravated. 

4. The faeces before the exhibition of the cathartics, were small in 
quantity, required a large dose of the purgatives, and in every instance 
were black and fetid. -And lastly, 

5. When the disease was cured, the appearance of the fceces became 
natural (p. 30). 

323. Upon the whole, the connection of the disease with the state of 

the intestinal discharges seems evident ; and as in all the five cases fetid, urease 
dark-colored evacuations preceded the cure, it would appear that, with }{^i im ^. 
them, the cause of the disease was removed. We may, therefore, legit i- riUe8 - 
mately conclude that the involuntary mottims, debiMty^ and other symp- 
toms,, were in these cases prod/uced by local irritation in the bowels, 
which was afterwards communicated to the whole system, through the 
medium of the nerves (p. 31). 



The tonic 
purga- 
plans 
compared. 



84 THE DOCTRINE OF PURGATION. 

324. All systematic writers have considered chorea as a disease of 
and he purga C - debility, and the same opinion has been almost universally adopted by 

practical physicians, who, seeing their patients laboring* under evident 
debility, have ransacked the whole materia medica for tonics and anti- 
spasmodics. Under this treatment, chorea has always been considered 
very difficult to cure. Now, when we compare the frequent failures of 
the tonic plan of cure with the invariable success of the purgative, we 
must conclude, in direct opposition to the hypothetical dogma of Brown, 
that the symptoms of chorea do not depend primarily on debility, but 
that the debility is merely symptomatic qj the disease. But in whatever' 
manner the phenomena of these cases may affect the theory of the dis- 
ease, they establish incontrovertibly a much more important conclusion 
— that it yields readily to the repeated and continued use of drastic 
purgatives (pp. 33, 34). 

Abejrnetht, John, M. D., Sicrgical Observations on the Constitutional 
Origin and Ireatment of Local Diseases. London, 1806. Eighth 
Edit, 1826. 

325. That the stomach and bowels are disordered by injuries and dis- 
Sympathy ea ^es of the parts of the body has been remarked by various persons ; 

between the fo^t the subject has never been extensively surveyed, nor viewed with 
other parts that accuracy of observation which its high importance merits. It has 
of the body, j^^ observed that sprains of tendinous or ligamentous parts produce 
sudden sickness ; and Mr. Hunter has attributed that shivering which 
is consequent to accidents, and attendant on some diseases, to the state 
of the stomach. It is known that in some local injuries from accident or 
operations, the stomach has appeared to be the part principally affected. 
But remarks on the affections thus induced in the digestive organs have 
been made only in a cursory manner. ... It also appears to me, that 
the connection of local diseases with the state of the constitution in gen- 
eral is either not sufficiently understood, or not duly regarded by the gen- 
erality of practitioners (p. 5). 

326. The operation for hernia (in a certain case) was followed by 
mmia g enera ^ disorder of the system, manifested by a full and strong pulse, 
from accu- furred tongue, great anxiety, restlessness, and total want of sleep. The 
fetid matter stomach was particularly affected, being distended, uneasy on compres- 
Zfplrs'ver- S ^ 011 ' an d ejecting everything that was swallowed. Tie was bled largely 
ance in the i n the evening, and took saline medicines, but could not be prevailed 
% 'Ian? l upon to swallow anything else except some toast and water. The sick- 
ness had in some degree abated on the next day, a solution of sulphate 
of magnesia in mint- water was prescribed, in small doses, given at regu- 
lar intervals, in order to relieve the disorder and distension of the stom- 
ach by procuring discharges from the bowels. In the course of the day 
the salts were administered which were not rejected by the stomach ; 
yet he could scarcely be prevailed upon to take anything else. The 
tongue was still covered with a thick yellow fur ; the skin was hot and 
dry, and the pulse frequent. As there was no particular tenderness 
about the epigrastic region, he was not again bled. The second night 
was passed without sleep. As the salts had produced no effect, the same 



THE DOCTRINE OF PURGATION. 85 

medicine was ordered in an infusion of senna, with the addition of some 
of its tincture, which by being given in very small doses, was retained. 
When, however, it seemed likely that no effect would result from this 
medicine, a grain of calomel was given at night, and repeated on the 
following morning. Still the loathing of food continued. The third 
night passed like the former ones without sleep, and in great anxiety. 
On the next morning two pills, containing five grains of the pil. colo- 
eynth and the same quantity of the pil. aloes cum myrrha, were given 
every fourth hour. They procured no stool, nor produced any sensation 
which inclined the patient to believe they would operate. Again he 
passed a sleepless night, but toward the morning he felt his bowels 
apparently filling, to use his own expression, and a profuse discharge 
ensued. A dozen copious, fetid and black evacuations took place 
between jive and ten o'clock, and he had several others in the course 
of the day j after which his appetite returned, his tongue became clean, 
and a sound and pleasant sleep succeeded, from which he awoke appa- 
rently well (pp. 7-10). 

327. It is most probably the disorder of the brain first affects the 
stomach • but the reaction of the latter affection is liable to increase and Th&wiwU 
maintain the former, by which it had itself been produced. The effects •?«<«» s f m " 
that result from the sympathy of the whole constitution with local with its C ev- 
disorder vary greatly both in nature and degree (p. 8). I could relate ery part# 
numerous cases in support of the inference, that local irritation acting 

on the nervous system may affect the digestive organs in a very serious 
manner, and thereby create great disorder of the whole constitution, 
which is afterward alleviated in proportion to the amendment that en- 
sues in the state of those viscera. Such cases of great local irritation must 
frequently occur to every one ; it is, therefore, unnecessary to adduce 
more instances to support the opinions here delivered (p. 12). 

328. With respect to the treatment of cases of this description, it 

may be right to acid, that the primary object should be to produce secre- 0l fi Vomu- 
tion from the irritable organs. In the case which has been related, and i? '^ r ° e ^ he 
in many others recorded in this volume, the effect of secretions from the opium but 
disordered organs in relieving their irritable state is very manifest. In l u V es purga " 
many instances opium will not prevent the continual efforts to vomit, yet 
when by sulphate of magnesia, or purgatives administered in the form 
of pills and clysters, stools are procured, the vomit ng ceases, the stom- 
ach retains both food and medicine, and general tranquillity of consti- 
tution is as suddenly restored (p. 13). 

329. A slighter degree of disorder occurs in the advanced stages of 
lumbar abscesses, diseased joints, compound fractures, and all kind 
of local disease, which impart considerable and continued irritation to SSaajn 
the whole constitution. We also find a less important disease, as, for 
instance, a fretful ulcer, keep up a disorder of the system in general, or s an3 
and of the digestive organs in particular, which subsides as the irritable 
state of the ulcer diminishes (p. 17). 

330. If the brain and nervous system should be disordered, without The nerv- 
any apparent local disease, similar derangements may be expected to J£S 
take place in the functions of the digestive organs (p. IS). gjjw or " 



Every ex- 
ternal dis- 



nection n Itb 
the digestive 



86 



THE DOCTRINE OF PURGATION. 



exarai 
of the 
tient neces- 
sary. 

" Restless- 

n ess and 

n ervous- 

ness" from 

disordered 

digestion. 



331. Patients commonly declare that they are in good health," except 
SnaSon that they feel disturbed by their local complaints ; yet they are found, 
P a - on inquiry, to have- all the symptoms which characterize a disordered 
state of the digestive organs. The mind is frequently irritable and des- 
pondent ; anxiety and languor are expressed in the countenance. The 
pulse is frequent or feeble, and slight exercise produces considerable 
fatigue and perspiration. The patients are sometimes restless at night, 
but when they sleep soundly they awaken unrefreshed, with lassitude, 
and sometimes a sensation as if they were incapable of moving! Slight 
noises generally cause them to start, and they are, to use their own ex- 
pression, " very nervous." These circumstances seem to indicate weak- 
ness and irritability of the nervous and muscular systems, which, in 
addition to the disorder of the digestive organs, are the chief circum- 
stances observable relative to the general health. By correcting the 
obvious errors in the state of the digestive organs, by the judicious 
administration of purgatives, local diseases, which had baffled all 
attempts at cure by local means, have speedily been removed, and the 
patient has acknowledged that such an alteration has taken place in his 
general health as greatly excited his surprise (pp. 21, 22). 



Imperfect 
digestion — 
various ef- 
fects : pro- 
duces gas ; 
impoverish- 
es the blood; 

disorders 
the brain, 
the muscu- 
lar system,, 

(&c. ; i. e. 
causes local 
diseases. 



332. When digestion is imperfect, gaseous fluids arc extricated from 
the alimentary matters. Vegetable food becomes acid, and 'oils become 
rancid. Uneasy sensations are also felt, and undigested aliment may be 
found in the feces (p. 24). 

Imperfect digestion must influence the qualities of the blood, and all 
parts of the body may be affected from this source (p. 65). 

Disorders of the digestive organs may produce, in the nervous sys- 
tem, a diminution of the functions of the brain, even so as to produce 
apoplexy and hemiplegia (p. 70). It may produce, in the muscular sys- 
tem, weakness, tremors, and palsy, or the contrary affection of spasms 
and convulsions. It may excite fever, by disturbing the action of the 
sanguiferous system, and cause various local diseases, by the nervous ir- 
ritation which it produces, and by the weakness which is consequent on 
nervous disorders or imperfect chylification (pp. 71, 72). 



333. 



Indigestion 
or constipa- 
tion — fur- 
ther effects 
of. 



Being in a warm and moist 



place, the undigested food will un- 
dergo those chemical changes natural to dead vegetable and animal mat- 
ter ; the vegetable food will ferment and become acid, the animal will 
grow rancid and putrid. . . These effects must continually take place, 
unless, by the digestive power of the stomach, the food is converted into 
ajiew substance which is not liable to these chemical changes. Such 
irritating compounds cannot fail to be detrimental to the whole tract of 
the alimentary canal. Part of the food thus changed will be absorbed 
from the bowels and render the blood impure, from which there is no 
outlet for various kinds of matter but through the kidneys, and this may 
prove a cause of foul urine, as well as of the presence of many sub- 
stances in that fluid not natural to it (pp. 74, 75). 



ah ur- 334:. Persons may be purged without having their bowels cleared of 
games are the fecal matter which may be detained in them. We should therefore 
efficient 1 * y endeavor to ascertain what kind or combination of purgative medicine 
will excite a healthy action of the bowels (p. 89). 



THE DOCTRINE OF PURGATION. 87 

335. The principle that should govern our conduct in the adminis- iiowtore- 
tration of purgatives may be briefly stated ; the excitement is to he re- SKstrs? 6 
peated till the requisite action is induced, yet no single excitement being jjjg^ pur " 
such. as may prove an irritant to the organs (ibid.) 

336. I am aware that laxative medicines may relieve irritation merely 

by augmenting the natural secretions of the viscera, and thus unloading Laxative 
their vessels ; and also by determining the fluids from the head, when ^St effect" 
the nervous symptoms are aggravated by a plenitude of the vessels of 
the brain. As I have found the lenient plan of treatment — that of ex- The lenient 
citing the peristaltic action of the bowels, so as to induce them to clear p an ' 
out the whole of their contents, without irritating them (so as to produce 
what is ordinarily called purging), particularly successful — I have rarely 
deviated from it. I am not, therefore, warranted from experience in 
speaking decisively respecting the more free use of purgative medicines 
(pp. 90, 91). 

337. The most judicious treatment will not remedy the disease if the Disease 
exciting causes continue to operate — such as improprieties of diet, agita- 'JJeTlhiie 
tion of mind, sedentary habits, or impure air (p. 96). its caus& 



338. It is necessary to the cure of disorder, first, that the stomach 
should thoroughly digest all the food that is put into it ; secondly, that 
the residue of the food should be daily discharged from the bowels teeweV 
(pp. 99, 100). 

339. The profuse discharges which sometimes follow the continued 
exhibition of purgatives consist of morbid secretions from the bowels f Ch f^* e ^ 
themselves, and not of the residue of alimentary matter detained in 
those organs (p. 35). 

The stools, which resemble pitch, are principally composed of diseased 
secretions from the internal surface of the intestines (p. 36). 



What is 
necessary 



of evactia- 
tions. 



Tetanus 
from consti- 
pation. 



340. All the experience which I have had relative to the treatment 
of tetanus (locked-jaw) has convinced me that more benefit is obtained by 
correcting the errors of the digestive organs than by any other means. It J Purgation 
may be useful to mention one case as a striking proof of this fact : A au^eSemai 
man who had been wounded in the foot, was brought about ten days ,e8Ions - • 
after the accident to the hospital, and so violent and general were the 
spasms that it was scarcely expected he could be taken to his bed alive. 

The jaw was fast clenched, and the muscles of his back and belly rigid ; 
convulsive actions came on frequently, and then all his limbs were vio- 
lently affected. His bowels had not been relieved for many days. When, 
after twenty hours, his bowels were purged, the discharges were not like 
faeces, and so extremely offensive that the patient could not stay in the 
ward. From this time, however, there was a complete subsidence of the 
Bpasm, and the patient recovered seemingly in proportion as the digestive 
organs regained their healthy functions (p. 130). 

341. A female patient, about twenty-seven years of age, was lately Paralysis 
admitted into the hospital for paralysis of the arm, which had come on lected state 
suddenly. She complained of much pain when pressure was made along ^l' 1 ", !,';'%- 



88 



THE DOCTRINE OE PURGATION. 



cont'nued 
purgation. 



Chronic 
croup 
Purge* re- 
move the 
cause. 



the outer margin of the scalene muscles, where the nerves emerge that 
form the axillary plexus. Her digestive organs were greatly disordered, 
and, in one week, by means that could only operate directly on those 
organs, she regained the use of her arm (p. 132). 

A gentleman of the medical profession, whose digestive organs haa 
been long disordered, suddenly lost the use of his right arm, without any 
apparent disturbance of the cerebrum. A professional friend asserting 
that the paralysis was a consequence of the disorder of the digestive 
organs, the patient promised strictly to adhere to any course of medicine 
that his friend would prescribe. The only medicines ordered were pills, 
containing two grains of calomel, at night, and purges on the following 
morning, for one week. The bowels were cleared daily. On the sixth 
day, however, several copious, dark-colored and offensive discharges took 
place, and the patient immediately regained the use of his arm (p. 132). 

Blegborough, Henry, Surg., On Chronic Croup. London, 1806. See 
Med. and Phts. Journ., 1806, Vol. XV. 

342. When the disease has subsisted some days there is generally 
thick and short breathing, with heat of skin and frequent pulse ; but as 
these symptoms are always relieved by a calomel purge, I conclude they 
are produced by loaden bowels. Being removed, they always in a few 
days return, and are, by the same means, again and again relieved 
(Journ., p. 509). 

Bradley, James, Surg., On Hernia. Huddersfield, 1806. See Med. 
and Phts. Journ., 1806, Vol. XVI. 

343. Mr. Bradley gives seven cases of hernia in patients of different 
ages, sexes and constitutions, demonstrating his method of employing 
the taxis in inguinal or scrotal hernia. Generally costiveness precedes 
the hernia, and vomiting accompanies it. On the employment of pur- 
gative medicines he says : 

In case seventh, the cathartic solution was administered from evident 
symptoms of enteritis; and here, as well as in case tirst, where this 
medicine was administered, I could not perceive any of those unpleasant 
effects ascribed to purgatives in general. The small quantity taken into 
the stomach not proving sufficient to increase the disorder of that organ, 
and the position in which the patients were placed, might tend, perhaps, 
in some measure to obviate any increased distress arising in that quarter. 
I gave this medicine, not with a view of obtaining any laxative effects, 
but as a cooling sedative, calculated to abate irritation in the first pas- 
sages, under the circumstances of a quick pulse, considerable thirst, and 
great pain in the abdomen. I was led to adopt this remedy in prefer- 
ence, from observing its good effects in enteritis, and in obstinate con- 
stipations of the bowels attended with colic, which I have seen it fre- 
quently remove, before ant laxative effects have been produced 
Journ., p. 48). 

Morgan, Charles, M. D., On the Use of Purgative Medicines. See 
Edinb. Med. and. Surg. Journ., Vol. II, 1806. 

Purgation 344. Debility is itself an effect of disease, and, when the disease is 
biuty. e ' removed, the strength and vigor of the system will return. Have we 



PTern>'a. 
Purgatives 

useful as 
cooling sed- 
ative, re- 
moving the 
irritation in 
the primes 
vite. and pro- 
moting the 
reduction. 



of 



THE DOCTRINE OF PURGATION. 80 

not often seen the debility which attends some of the complaints of in- 
fancy removed, as well as the disease of which it was a symptom, by 
evacuating the bowels j and nausea., and anorexia, with all the depress- 
ing symptoms of dyspepsia, how often alleviated by a brisk purgative? 
(p. 100). 

345. If we would follow out this practice on general principles, we 
must calculate the whole effect of onr remedies. Sometimes we empty the Effects 
bowels simply ; at others we promote an increased secretion of fluids by v J^ot P u* 
purgative medicines. In some cases it appears sufficient to unload the </«<*'<"<• 
bowels of their contents accumulated by long retention, and thereby 
relieve the system from the effects of this local irritation ; but in others, 
and especially in those in which a freer and more continued purging be- 
comes necessary before the symptoms yield, we bring off not only the 
contents of the bowels which are out of the course of circulation, we 
eliminate also the secretory organs which terminate in the intestinal 
canal — the obstruction, torpor, or deranged actions of which may have 
been a chief cause of the morbid actions of other parts of the system 
(ibid.) 

3±6. We are surely authorized to make this inference from cases in r 
which the purging is continued for weeks, to the exhibition of three or tion as the 
four stools daily, with progressive relief of the morbid symptoms, with uZSSIfm 
improved looks and strength, and at length followed by the perfect cure to'^tith'L 
of a complicated disease. In other cases we find the cure advancing vestured. 
with the discharge of fetid stools of ei bilious appeeirance, or black and 
greenish color (p. 101). 

347. Having been an eye-witness of Dr. Hamilton } s practice, I could The danger 
not avoid being struck with its simplicity and success, and adopting it %wgin% 
as my own. Much dissatisfaction may have arisen among practitioners, 6W # v ^ 7tW y- 
from the unwillingness of patients to submit to a repetition of purga- 
tives, who all esteem purging a debilitating operation, and think them- 
selves " far too nervous " to undergo it with impunity. Many too, I 
believe, are disappointed in their hopes of cure, by stopping short of the 
wished-for point (ibid 1807, vol. III. p. 144). 



348. Both these evils may arise from a neglect on the part of the 



Always etc- 



stoole. 



medical adviser. I mean, not inspecting the stools. If the practitioner amine the 
be too much an." emunctse naris homo to submit to such a drudgery, 
let him go <>n trusting to remedies that have long failed, or rather let 
him lay aside the practice of medicine altogether. It is only by daily 
■/ion of the stools that t/i^jjurgi/nj can, be regulated • for, as long as 
they exhibit mokuid appearances, so long abb purgatives nboessaky, 
and no longer. 

When the stools are not seen, tlie patient conceives that he is discharg- 
ing far more than you are aware of, and more than his constitution can 
bear. By an earnest inquiry after them and a strict injunction that the 
whole may lie saved, together with an occasional appeal to the patient, 
whether such matters can remain in the body wiih impunity, I have 
never tailed in inducing a cheerful submission to the plan, and the pa- 



90 THE DOCTRINE OF PURGATION. 

tient at last looks for the repetition of the doses as a sure relief from the 
misery he is suffering. Having premised these remarks, which arise 
from the objections of several medical friends, I proceed to the relation 
of two cases, not picked out as proving more than others, but as exhib- 
iting the obstinacy of the disease, and the ultimate advantages derived 
from a steady perseverance in the purgative plan (p. 145). Here follow 
the cases : 

Walsh, E., M. D. An account of a malignant fever, which appeared 
in the Garrison of Quebec during the Autumn of 1805, with some 
preliminary observations on the diseases of the Canadas. London, 
1806. See Mel>. and Phys. Journ. 1806, vol. XV. 

Lake fever. 349. Lake Fever. — The cure of this fever is not less easy and cer- 

Ernekc and tain at its commencement, than difficult in its advanced stages. An 
ns purg an ti mori i a i emetic, followed by a brisk purge, with attention to regimen 
for two or three days, seldom failed of curing it on the access. But if 
this was neglected, and the disease far advanced, such a torpor of the 
system was induced as frequently rendered ineffectual the most active 
medicines (Journ., p. 448). 

Dr. Walsh characterizes the malignant fever at Quebec exactly 
like Mr. Bennion describes the fever at Gibraltar, and has employed the 
same remedies against it ; confer, therefore, Bennion on the Gibraltar 
Fever (Journ., pp. 451-453). 

Cheyne, J., 31. D. Observations on the Effect of Purgative Medi- 
cines. London, 1808. See Edinb. Med. and Surg. Journ., 1808, 
vol. LV. 



Fits and 



350. Case of a youth who, in consequence of a fall, was subject for 
inability to a year to most distressing fits, intense pains, etc., and who, in conse- 
by purga- quence, had lost the power of walking. (Case given.) This boy in 
Uves - about two months was restored to health. During this period lie used 

a great quantity of strong cathartic medicine. A scruple of aloes and 
ten grains of gamboge were given daily for several weeks before his 
stools became natural ; and as his stools became large, loose and natural, 
the fits left him and he recovered the use of his limbs. About the end 
of my attendance, when his bowels were acting more naturally, one pill 
of the same kind, of which it before required sometimes ten to produce 
the desired effect, was a sufficient dose (pp. 310, 311). 

In this case our practice is supported by analogies drawn from the 

successful treatment of other diseases where, along with convulsions or 

a%cZnf w spasmodic affections, we have also been able to detect a great degree of 

foulness in the bowels. It is in compliance with a common idiom that 

I use the expression of foulness of the bowels. I am persuaded that 

such a state cannot, with any propriety, be said to exist. Take the 

In mmlni S ^ 0W ^ n f an ^ e remittent of Dr. Batter, or the marasmus of Dr. LLam- 

marasmus. ilton — we lvave a train of symptoms supposed to be induced by foulness 

of the bowels ; and the appellation seems to be countenanced by what 

is observed during the cure, the effects of. the purging medicines 

retid stools, employed. By these medicines stools are procured, at first dark, slimy 



THE DOCTRINE OF PURGATION. 



91 



and fetid, which perhaps, for a considerable time, have nothing of the 
appearance of natural fasces ; the evacuations seem merely a collection 
of vitiated secretions, but at last, by pursuing the purgative plan, large 
natural stools are evacuated, and it is generally supposed that these 
stools have been all the while lodged in the intestines, and, that our 
medicines were not powerful enough at once to expel them — that the dis- 
ease was solely from an accumulation of fecal matter (p. 312). 

351. But the fact is, that these critical stools are produced by the 
restoration of the viscera to a healthy condition. The purgative medi- 
cine employed is useful, not so much by removing the accumulations, 
but that it stimulates the bowels. By the steady application of this 
stimulus the visceral functions are restored. The bilious and slimy 
stools are expelled, the light food is concocted, and from the fecal resi- 
duum, with the increased supply of gall, of gastric and pancreatic fluids, 
and the secretions from the large intestines, in consequence of the reno- 
'vation of the organs supplying these fluids, the large natural stools are 
produced and tlte disease resolved. Were the bowels in a healthy con- 
dition, they would be acted upon by what at all other times is their 
natural stimulus, and, consequently, they would not admit of this sup- 
posed accumulation. If there be accumulation, the torpid state of the 
intestines is the cause of it ; but the disease may exist without any accu- 
mulation whatever (p. 312). 



Powerful 
purgation. 



Critical 

evacuations 
by stool. 



Critical or 
fetid stools 
indicate re- 
inoval of dis- 
ease and re- 
turn of 
healthy ac- 
tion. 



352. In dysentery, where hardened faeces are lodged in the bowels, 
we see a constant succession of unsatisfactory stools, and of these stools 
the hard fasces or scybala would seem often to be the cause. For, it is 
observed by every practical writer, that when, by proper purgatives, the 
scybala are evacuated, there is immediately a remission of the most 
urgent symptoms, in particular of the tenesmus, and frequent mucous 
stools (p. 313). 



Dysentery 

from 

scybala. 



353. Hydrocephalus. — The cure. The exhibition of the largest dose 
which can be safely prescribed of some powerful cathartic medicine, 
two, three, or four times a day; and this continued for several days, or 
until natural stools are produced. The advantage of keeping the intes- 
tinal canal under the continual influence of a stimulus, I have, in 
various instances, found to be so great, that I am induced to repeat the 
declaration of my belief, that the happiest result may be expected from 
this measure. {Essay on Hydrocephalus Acutus, Edinb., 1808 ; ibid., 
p. 316.) 

Gay, M., M. D., An Essay on the Nature and Ireatment of Apoplexy. 
Paris, 1808. Translated by Ed. Copeman, Surg., with an Ap- 
pendix. London, 1843. See Brit, and For. Med. Rev., 1813, Vol. 
XVI. 



Water in 
the brain — 
cure by the 
fullest pur- 
gation. 



351. This treatise proves that bleeding is injurious in^ all cases of N A J^S t 
apoplexy, and that the primary cause is always to be found in the primse hmpurge' 
viae ; that purgatives are indicated in every ease, except when t lien I taclc 
follows a full meal, when emetics should be first administered (Rev., 
272). 



92 



THE DOCTRINE OF PURGATION. 



Halliday, Andrew, M. D., On Epilepsy. 
and Phys. Journ., 1808, Vol. XIX 



Blandford, 1808. SeeTAisD. 



Epilepsy 
from worms. 



Continued 
•purgation 
removes the 
cause by 
carrying off 
accumula- 
tion of 
morbid 
matter in 
the intes- 
tines. 



355. Case given of a girl of five years old who was subject to fits with 
violent contraction of the limbs, had an unnaturally voracious and de- 
praved appetite, and could articulate but very few words, however she 
understood what was said to her. 

Upon an attentive consideration of this case, it occurred to me that 
purgatives were likely to be of service, and from my intimate acquaint- 
ance with the practice of that justly-celebrated physician, Dr. Hamilton, 
of Edinburgh, I entered upon the treatment with great confidence, and 
did not hesitate to promise success to the parents of the girl if they 
would faithfully and implicitly follow my directions. I confess that I 
had my fears lest there should be some organic disease ; yet the pulse, 
though rather slow, was regular. The bowels, I was told, were very 
irregular, but- generally costive; I felt the abdomen very tumid; and 
notwithstanding the feebleness and emaciated state of the patient, I felt 
convinced that no time was to be lost ; I therefore ordered an active 
purgative. The fits recurring and no stool being procured, infusion of 
senna was given, one ounce every half hour, which produced several 
scanty, fluid motions, of a greenish color, and highly fetid. Both 
medicines were continued for four days, without alteration in the state 
of the patient or her bowels, several lumbrici were voided, the fits had 
rather increased in violence; on the fifth day she had two motions, the 
last very copious, consisting chiefly of hardened scybala, and containing 
two worms ; fits returned ouly during the night. Three days more 
brought more large evacuations of the same kind, diminished voracious- 
ness, and less severity of fits which occurred during the nights. From 
this time (the 6th of January) to the 20th, I continued the exhibition of 
calomel and rhubarb, and the senna occasionally, never intermitting 
more than one day. The quantity of feculent matter which she passed 
during that period is beyond conception. Her appetite began to nag 
about the 14th, and on the 16th her mother informed me that she had 
not had a fit for twenty-four hours ; on the 17th she had one very severe 
fit, but remained free from them again till the 20th, when she had one 
which did not continue above ten minutes. During this period she had 
voided three lumbrici. The fits gradually abated, the appetite became 
natural, while purging pills were continued so as to secure a regular 
alvine discharge (Journ., pp. 305-308). 



Large doses 
and perse- 
verance se- 
cure 

SUCCESS. 



356. Thus far the purgatives have fully answered my expectations. 
The child appears to be cured of her fits, but I am afraid she will remain 
an idiot while she lives. The doses of medicine that were necessary to 
move her bowels were very large, and also the length of time which 
elapsed befom the bowels could be said to be properly moved, for I con- 
ceive that she had no proper motion till the seventh day. The large 
doses of medicine which were necessary may be accounted for, perhaps, 
from the state of the sensorium ; and the difficulty which there was in 
moving the bowels was, no doubt, owing to the great accumulation 
which had taken place (p. 308). 



THE DOCTRINE OF PURGATION. 



93 



357. Though the fits are removed at present, I fear they will be apt 
to return, unless great care is taken to keep her bowels open for some 
considerable time, until the predisposition from habit is overcome, and 
the bowels are restored to their natural tone y but it' this is attended to, 
I am certain the cure will be complete. This case, then, I would say, 
tends to corroborate the very valuable observations of Dr. James Ham- 
ilton, but indeed those observations stand in no need of any such testi- 
mony ; for Dr. Hamilton has proved every position which he has 
advanced by facts that never can be controverted. The novelty, the sim- 
plicity, and the efficacy of Dr. Hamilton ] s practice attracted much notice 
on the first appearance of his invaluable work ; and as the doctor did 
not venture to give his discoveries to the world till experience had most 
fully confirmed them, he was able to speak with certainty ; and I will 
venture to affirm that if purgatives have failed in any instance to pro- 
duce the efiects which Dr. Hamilton's observations have so incontestibly 
proved them capable of producing, that that failure is to be attributed 
more to the prescriber than to the medicine prescribed (Journ p. 309). 



It is neces- 
sary to estab- 
lish regu- 
larity of al- 
vine evacua- 
tions in ol- 
der to. secure 
health. 



The pit rela- 
tive, plan of 

treatment 
and Hamil- 

ton , s doc- 
trine vindi- 
cated. 



dication of 
the purga- 

live, plan 
and Hamil- 
ton's prac- 
tice. 



358. I nave often heard it argued, by those who were unwilling to Typhus. 
give too much credit to Dr. Hamilton, as was generally allowed, that 
though no doubt the cases which he had related seemed to prove the 
good efiects of purgatives, yet that many of those cases — for example, Fu-ther vm 
his cases of typhus fever — were so trifling that any other remedy would 
have done as well as purgatives. And, moreover, it has been often 
hinted that though this practice may do very well in the north, and in 
the Royal Infirmary of Edinburgh, yet that it is by no means calculated 
for the delicate constitutions of this country. I shall only say, that 
those who have witnessed Dr. Hamilton^ practice have been fully con- 
vinced of the good efiects of purgatives in severe as well as slight cases 
of fever ; and, indeed, had the doctor felt any anxiety about this, he 
might have filled the second number of his appendix with cases more 
severe than any he has given. With regard to the second hint, I can 
add my testimony to that of Dr. Morgan, of Dover. (See Edinb. M. 
and S. Journ., 1807, April 1.) 

I have prescribed purgatives in different diseases since my residence 
in England, and have found their efiects uniformly the same as in the 
north. While I resided at Ilalesworfh, in Suffolk, I attended Robert 
White, of Walpole, with Mr. Walker, surgeon, in one of the worst 

- of typhus I ever saw. The disease was speedily subdued by pur- 
gatives. The bolus jalapre compositus had the same good eifect in Suf- 
folk as in the Royal Infirmary of Edinburgh (Journ., pp. 309, 310). 



Watt, Robert, M. D., Cases of Diabetes, Consumption, dec, with Ob- 
servations on the History and Treatment of Disease in general. 
DoAsley, 1808. See Edinb. Med. & Surg. Jour., 1809, Vol. V. 



359. The fi/Mctions of the lungs are twofold : to assimilate the new T1be Iwn(/M; 
materials supplied by the digestive organs, and to preserve the blood in "^j* 1 ^""' 1 
a healthy state. In health there must be a due balance between the di- 
gestive and assimilative organs. If this balance be disturbed, disease 
ensues (p. 93). 



94 



THE DOCTRINE OF PURGATION. 



chyle. 3go. If more chyle be thrown upon the lungs than they can assimi- 

late, it must remain an incumbrance upon the system, or be discharged 
by one or other of the excretories (p. 94). 

361. The Mood may be deteriorated, and yet support life, in an im- 
perfect manner. The vessels which increase and repair the solids may 
be in want of proper materials, though the system were overcharged 
with blood. The nervous system being deprived of its natural support . 
from these vessels, acquires a depraved sensibility, and all the phenomena 
follow which we have described as attending a diseased habit. The 
greatest number of secreting organs are idle for the want of arterial 
blood, the only stimulus which can call them into action. The liver 
receiving its stimulus from venous blood, has more to do than in health ; 
hence arise " bilious complaints " which, with low spirits, prostration of 
strength, &c., generally mark the first stage of disease (p. 94). 

362. If the system possesses sufficient vigor, reaction takes place, and 
goes on to a proper crisis. ... In place of fever the balance is often 
restored by a critical evacuation. If the superfluous matter take to the 
intestines, it produces diarrhoea / if to the kidneys, diabetes / if to the 
uterus, menorrhagia / if to the skin, profuse perspiration. If the re- 
action fail to produce a salutary crisis, the system falls back, collects 
new vigor and resumes the conflict, as in intermittent fever, and other 
periodical diseases. In other instances, such as hypochondriasis, it re- 
peats the same thing over again, or tries other means of relief, and is 
thus said to counterfeit every disease ; that is, it employs many efforts 
to throw off the incumbrance, but is generally unequal to the task. Af- 
ter a longer or shorter struggle, a confirmed phthisis, diabetes, diarrhwa, 
dropsy, or some other disease, termi mites the patient's sufferings (p. 95). 

363. In every period of the history of medicine, there has not only 
been practice opposed to practice and theory to theory, but one fashion 
has succeeded another with astonishing rapidity. One practitioner 
treats burns and scalds by heating, another by cooling applications ; one 
cures the gout by carefully wrapping the feet in flannel, another by 
plunging them in cold water ; one combats fevers with wine and opium, 
another by gruel and purgatives. These, though abundantly striking, 
are but a small sample of the oppositions in medicine. To notice the 
fashions would be to enumerate the various articles which, from time to 
time, have entered the materia medica, and almost every possible man- 
ner in which these can be prepared and compounded. (Journ, 1810, 
Yol. VI, p. 287.) 

364. From a belief that there is no disease without a corresponding 
remedy, medical men have been much in search of antidotes. The task 
of finding a specific for each disorder, reminds me of the labor of the 
Chinese in inventing a distinct character for every word in their lan- 
guage. However numerous and diversified the hair-splitting systems of 
nosology may represent diseases, the means of cure, like the simple 
sounds in language, are few and obvious. Galen remarked that bleed- 
ing and purging were the two legs of physic, and it is doubtful how 

rwgattoes f ar ^ e ar ^ ^ ias ^ een improved by the legs which have since been added 

the"legso/ (ibid.) 

phywe." x ' 



The blood. 



The nerves. 



Secreting 
organs. 
The liver. 
" Bilious 

com- 
plaints" 
debility. 



Reaction. 



Critical 
evacuation: 
IMarrhcea — 
intestines ; 
Diabetes — 
kidneys ; 
Menorrhagia 

— uterus ; 
Perspiration 
— skin. 
Hypochon- 
driasis — its 

causes, 
course, and 
end, if im- 
purities are 
not remov- 
ed, 



Vagaries o 
medical 
practice. 



About " 
cifics 



THE DOCTRINE OF PURGATION. 95 

Bkiggs, H., M. D., Physician of the Royal Dispensary of Liverpool ; 
History of a case of tetanus eared by purgatives. Liverpool, 1809. 
See Edinb. Med. & Surg. Joukn., 1809, Vol. V. 

365. Remarkable case of Lake Gaskell, given in detail. — The cure 

was perfect in four weeks. On the fourth day of the case, Dr. Briggs '—remark™ 
says: — " I had all along been aware of the awful responsibility. I in- c J?eby5^- 
currred by departing so widely from the usual practice in tetanus, and e 'f ( ' ( l t /™ r ' 
now my resolution failed me altogether. I was terrified with the ap- "Niuespe- 
prehension that I had already delayed the free exhibition of opiates too 
long, while yet I was loth to relinquish the use of purgatives (p. 154). 
On a cool review, I asked myself whether, if the case should prove 
fatally, as I then feared it would, I could with justice affirm, that purga- 
tion had been fairly tried and failed, whether on the contrary the ex- 
acerbations that had occurred ought not to be ascribed to the interrup- 
tion of the plan, rather than to the plan itself? (p. 155). Finally, I con- 
cluded to adhere to the plan of purgation, and to discontinue the inter- 
nal use of opium (ibid). 

366. After the cure, he says : — " If there be any point in medicine, spa*™* of 
on which, after having been engaged in dispensatory practice for sixteen th6Stomach - 
years, I have arrived at any certain conclusion, it is this, that in gastro- 
dynia, and many other spasmodic affections, brisk purgatives will be 

found incomparably better antispasmodics than any of that tribe to theSest" 
which this epithet is usually applied. I believe, too, that their operation "jj^c?."*" 
is strictly antispasmodic — that their first effect is, to supersede the 
spasmodic action ; for I have often known complete relief to be obtained 
before a stool was procured, in so much, that I have more than once 
been asked by patients, ' if I had not given them laudanum V " (p. 161). 

I am inclined to think, that the more drastic purges were laid aside 
for no sufficient reason. . . The more active purgatives appear literally p"% 
to have possessed antispasmodic virtues (p. 162). 

The quantity of medicine taken from first to last for twenty-five 
days is certainly very large, as follows : — calomel 320 grains, scammo- 
nv 340 grains, gamboge 126 grains, powdered jalap 6 ounces, infusion 
of senna with tincture lOf pounds, colocy nth-pill nearly 2 ounces, of 
which the greater part was taken within the first week. 

During forty-eight hours (on the 5th and 6th days) was given scam- 
mony 210 grains, gamboge 89 grains, jalap 1^ ounce, infusion of senna 
2^- pounds, calomel 80 grains; and all this without causing sickness or 
griping, but on the contrary with most decided benefit (ibid.) 

, 367. In short, if a remedy be indicated at all, surely the dose should be 77^, effect, 
regulated, not only by' weight and measure, but by the effect. And when n $y h 2n£e 
there is such a strong concatenation of morbid actions, as in tetanus, it Jjjjajjijj 
might perhaps have been expected, a priori, as it has proved in fact, that 
nothing hit tie most active purges, in large doses, and, frequently re- 
peated, would avail to break tJie train (p. 163). The whole quantity of 
vpvum taken was 100 drops in two days, and so far from answering any 
good end, it seems manifestly to have prevented sleep, as well as to have 
impeded the operation of the purgatives (p. 164). 

This i< the most important evidence, in respect to purgatives, we have yet published. 
Our directions for the use of Brandreth's Pills need no modification. Dose, from 2 to 20, or 
any quantity required to purge. 



Drantic 



96 THE DOCTEINE OF PURGATION. 

Rush, Benjamin, M. D., Medical Inquiries, 4 vols. Philadelphia, 

1809. 

Disease a 368. There is but one fever. However different the predisposing, 
remote, or exciting causes of fever may be, still I repeat, there can be 
but one fever (vol. III., p. 16). 



unit. 



aii forms 369. I infer the unity of fever, further, from the sameness of the 
° f <it?te.!°' products or effects of all its different forms (ibid., p. 17). All ordinary 
miwWer- l' ever being seated in the blood-vessels, it follows, of course, that all 
ous system, those local affections we call pleurisy, angina, internal dropsy of the 
brain, pulmonary consumption, and inflammation of the liver, stomach, 
bowels, and lungs, are symptoms only of an original and primary dis- 
ease in the sanguiferous system. The truth of this proposition is ob- 
vious, from the above local affections succeeding primary fever, and 
from their alternating so frequently with each other. There being but 
one fever, of course 1 do not admit of its artificial division into genera 
and species (ibid. p. 33). 

N arravi C e lL ^70. Pulmonary consumption is sometimes transferred into head- 
mmts of ais- ache, rheumatism, diarrhoea and mania. The bilious fever often ap- 
tkmabieaad pears in the same person in the form of colic, dysentery, inflammation 
useless. Q f ^ ne y ivgy ^ i un g g an( j brain, in the course of five or six days. Phreui- 
tis, gastritis, enteritis, nephritis, and rheumatism — all appear at the 
same time in gout and yellow fever. . . . Much mischief has been done 
by nosological arrangement of diseases. They erect imaginary boun- 
daries between things which are of homogeneous nature (ibid., p. 34). 

consequen- 371. They gratify indolence in a physician by fixing his attention 
cSi°no^n- upon the name of a disease, and thereby leading him to neglect the 
ciature. ranging state of the system. They moreover lay a foundation for dis- 
putes among physicians by diverting their attention from the simple, 
predisposing and proximate to the numerous remote and exciting causes 
of disease, or to their more numerous and complicated effects (ibid., 
p. 35). 



The mate- 372. The whole materia medica is infected with the baneful conse- 
denou"ncecL a quences of the nomenclature of diseases, for every article in it is pointed 
only- against their names, and hence the origin of the numerous contra- 
dictions among authors who describe the virtues and doses of the same 
medicine (ibid). 

A fomtng, me 373.^ By the rejection of the artificial arrangement of diseases, a 
when the revolution must follow in medicine. Observation and judgment will 
mty v{\\te take the place of reading and memory, and prescriptions will be con- 



ease, 



edgedTnd ^ ned to existing circumstances. The road to knowledge in medicine 

acted upon, by this means will likewise be shortened, so that a young man will be 

able to qualify himself to practice physic at as much less expense than 

formerly, as a child would have to read and write by the help of the 

Koman alphabet, instead of Chinese characters (ibid, pp. 34, 35). 



THE DOCTRINE OF PURGATION. 97 

371. The efficacy of this remedy (purgation) in the cure of dropsies, Dropsy ;- 
has been acknowledged by physicians in all ages and countries (vol. 11, ^li 
p. 182). Both drastic and gentle purgatives act by diminishing the ac- 
tion of the arterial system, and thereby promote the absorption and 
discharge (ibid. p. 183). 

375. However va?ned morbid actions may be in their causes, seats ah diseases 
and effects, they are all of the same nature, and the time will probably (A^tbT^i 
come when the whole nomenclature of morbid actions will be absorbed 
in the simple name of " Disease " (ibid., p. 234). 

376. A mild remittent, and yellow fever are different grades of the 42*** 
same disease (ibid., p. 256). muted yei- 

Imo fever. 

377. If we mean by gout a primary affection of the joints, we have 
gained nothing by assuming that name ; but if we mean by it a disease 
which consists simply of morbid -excitement invited by debility, and dis- .nS™ 5 ^ 
posed to invade every part of the body, we conform our ideas to facts, u . ow JmpH- 
and thus simplify theory and practice in chronic diseases (ibid., p. 272). and%ractfce 

in chronic 
diseases. 



Gout; —a 

local deposit 
from general 



378. The gout affects most of the viscera. In the brain it produces Ooui con . 
headache, vertigo, coma, apoplexy and palsy: in the lunas. pneumonia, sumption, 

, . > & , ' > . r r - ; . r J m > / . Mi ' asthma, etc., 

notha, asthma, hemoptysis, consumption; m the tliroat, inflammatory an diseases 
angina ; in the uterus, hemorrhagia uterina ; in the kidneys, strangury, froT c ^m! m 
diabetes, and calculi ; in the liver, inflammation, suppuration, melea, 
schirrhus, gall-stones and jaundice (ibid., pp. 258, 259). All these dis- 
eases have but one cause, and they are exactly the same, however differ- 
ent the stimulus may be from which they are derived (ibid., p. 261). 

379. Thus rheumatism, the gout, the measles, small-pox, the different Local ajfeo- 
species of cynanche — all furnish examples of. the connection of local ^™«?2L 
alfections with general diseases ; but the apoplexy and the pneumony ease. 
furnish the most striking analogy of local affections succeeding a general 
disease of the system (ibid., p. 86). 

380. Pneumony is apoplexy of the lungs, allowing only for the dif- pneumom,. 
ference of situation and structure (ibid., p. 87). 

381. After the production of predisposing debility of the system unity of di*. 
fYom the action of remote causes, the fluids are determined to the weak- ^onsSai? 
est parts of the body. Hence the effusion of serum or blood takes place (tl - 

in the lungs. When serum is effused, apituitous or purulent expectora- 
tion takes place; when 1)1 ood is discharged a disease is produced which 
>cen called hemoptysis. The pneumony is produced by remote 
exciting causes which act on the whole system (ibid.) . . The expectora- 
tion which terminates the disease in health, is always the effect of effu- 
sions produced by a general disease (ibid., pp. 87, 88). 

382. Who lias not seen the pulmonary symptoms alternately relieved aon-naturp 
and reproduced by the appearance or cessation of a diarrhoea or pains in by^^oS 
the bowels 1 (Ibid., p. 85.) 

1 



98 



THE DOCTRINE OF PURGATION. 



The unity 
of disease. 



The recog- 
nition of this 
doctrine is of 
the highest 
importance 
to human- 



383. Science has much to deplore from the multiplicity 'of diseases. 
It is as repugnant to truth in medicine as polytheism is to truth in reli- 
gion. The physician who considers every different affection of the dif- 
ferent systems in the body, or every affection of different parts of the 
same system, as distinct diseases, when they arise from one cause, resem- 
bles the Indian or African savage who considers water, dew, ice, frost 
and snow, as distinct essences ; while the physician who considers the 
morbid affections of every part of the body, however diversified they 
may be in their form or degrees, as derived from one cause, resembles 
the philosopher who considers dew, ice, frost and snow, as different 
modifications of water, and as derived simply from the absence of heat 
(vol. III., pp. 146, 147). 

•Humanity has likewise much to deplore from this paganism in medi- 
cine. The sword will probably be sheathed forever as an instrument of 
death before physicians will cease to add to the mortality of mankind 
by prescribing for the names of diseases (ibid., p. 147. Account of the 
bilious yellow fever of 1793). 



experience 
of Dr. Rush. 



Franklin 

Oil YELLOW- ' 



Purgation in- 
dispensable. 
The abdom- 
inal viscera 

chiefly af- 
fected. 



384. How Dr. Hush came to believe in the efficacy of purgation. — 
Condensed from pp. 222-230, vol. III. : 

I gave gentle purges and vomits, bark in all its usual forms, applied 
blisters to the limbs, neck and head, attempted to rouse the system by 
wrapping the whole body in blankets dipped in warm vinegar (p. 223), 
rubbed the right side with mercurial ointment, with a view of exciting 
the system through the liver ; none of these remedies. were of any service. 
I returned to bark, wine, and the use of cold water (p. 224). . . Had the 
authority of Dr. Oleghorn for the former, who says : " The bark, by 
bracing the solids, enables them to throw' off' the excrementitious fluids 
by the proper emunctories," &c. No better success, however, attended 
my efforts (p. 225). . . I ransacked my library, and pored over every 
book that treated of yellow fever (p. 226). . . I recollected that I had 
among some old papers a manuscript account of the yellow fever as it 



uscripi 
which 



Purgation 

promotes 

sweat by re- 



prevailed in Virginia in 1741, which had been put into my hands by 
Dr. Franklin, a short time before his death. I now read it a second 
time, and paused upon every sentence. I was struck with the following 
passages (p. 227) : 

385. (Dr. FranMin, loquitur): "It must be remarked that this 
evacuation (meaning the purges) is more necessary in this than in most 
other fevers. The abdominal viscera are the parts principally affected 
in this disease, but by this timely evacuation their feculent corruptible 
contents are discharged before they corrupt and produce any ill effects ; 
and their various emunctories and secerning vessels are set open, so as to 
allow a free discharge of their contents, and consequently a security to 
the parts themselves during the course of the disease. By this evacua- 
tion the very minea of the disease, proceeding from the putrid miasmata 
fermenting with the bilious and other humors of the body, is sometimes 
eradicated by the timely emptying the abdominal viscera, in which it first 
fixes, after which a gentle sweat does, as it were, nip it in the bud " 
(ibid.) 

386. " When the primm via), but especially the stomach, is loaded 
with an offensive matter, or contracted and convulsed with the irritation 



THE DOCTRINE OF PURGATION. 



99 



of its stimulus, there is no procuring a laudable sweat till that is re- moving i m - 
moved ; after which a necessary quantity of sweat breaks out of its own whff^pr* 
accord, these parts promoting it, when, by an absterging medicine, they Jgjj exuda- 
are eased of the burden or stimulus which oppresses them" (p. 228). 

3ST. " All these acute putrid fevers require some evacuation to bring , au fevers 

them to a perfect crisis and solution, and that even by stools, which must Ration. 1 ™ 
be promoted by art, when nature does not do the business herself" 
(ibid.) 



388. " On this account, an ill-timed scrupulousness about the weak- 
ness of the body is of bad consequence in these circumstances ; for it is 
that which seems chiefly to make evacuations necessary, which nature is 
ever attempting, after the humors are lit to be expelled, but is not 
able to accomplish for the most part in this disease. And I can affirm 
that I have given a purge in this case when the pulse has been so low 
that it could hardly be felt, and the debility extreme, yet both one and 
the other have been restored by it " (pp. 228, 229). 



The weaker 
the subject, 
the greater 
the necessity 
tor full pur- 
gation. 



389. Here I paused. A new train of ideas suddenly broke in upon weak 
my mind. I supposed that my want of success, in several of the cases E^ 8 U9e " 
in which I attempted the cure by purging, was owing to the feebleness of 
my purges (ib., p. 230). 



effects of full 
2>ur//(tl'V7) — 
the seeming- 
ly dead re- 
stored to life. 



390. By full and continued puraation I cured perfectly four out of Astonishing 

i r> r* ^ J . • «.l , T r> <1 l l efftx'ta nf full 

the first foe patients, notwithstanding some ot them were advanced sev- 
eral davs in the disease. One gentleman had passed twelve hours with- 
out a pulse, and with a cold sweat on his limbs. His relations had given 
him over. Dr. MitcheWs account of the effect of purging in raising the 
pulse excited a hope that he might be saved, provided his bowels could 
be opened. Purges were given to him three or four times a day ; at 
length they operated and produced two copious fetid stools. His pidse * 
rose immediately. A universal moisture on his skin .succeeded. In a 
few days he was out of danger, and soon afterwards appeared in the 
streets in good health (p. 232). . . In three days he had taken eighty 
grains of calomel, and rather more than that quantity of rhubarb and 
jalap (ibid.) 

391. This practice could be said to be almost uniformly effectual in calomel with 
all those cases which I was able to attend. . . Many used calomel in opium "use- 
connection with bark, wine, and laudanum, without any good effects. 



I can never forget the transport with which Br. Pennington ran across 
Third Street to inform me " that after he began to give strong purgatives 
the disease yielded in every case" (ibid., p. 235). 

392. Never did I experience such sublime joy as I now felt in con- 
templating the success of my remedies. It repaid mo lor all the toils 
and studies of my life. The reader will not wonder at this joyful state 
of my mind when I add a short extract from my note-book of the 10th 
September: "Thank God! out of one hundred patients, whom I have 
visited or prescribed for, this day, J home lost none I" (Ibid., p. 234.) 



Dr. Pen- 
nington and 
strong 
purges. 

Dr. Ruxh re. 
ioices. 



100 THE DOCTRINE OF PURGATION. 

aii kinds of 393. My practice was, to give a purge every day while the fever con- 

fhSfreatob- tinned. I used castor-oil, salts, cream of tartar, rhubarb. Calomel and 

p^\tSa j a ^ a P were often ineffectual, then I added gamboge. The purges seldom 

da v- answered the intention for which they were given unless they produced 

four or five stools a day (ibid., p. 240). . . When purges were rejected or 

slow in their operation, I always directed opening clysters every two 

hours (ibid., p. 241). 

The advan- 394 The effects of purging were as follows : 

pwrgation 

se?en te prop - 1- It raised the pulse when low, and reduced it when it was preter- 
sitions. naturally tense or full. 

2. It revived and strengthened the patient. This was evident in 
many cases in the facility with which patients who had staggered to a 
close-stool walked back to their bed after a copious evacuation. 

3. It abated the painful symptoms of the fever. 

4. It frequently produced sweating, when given on the first or second 
day of the fever, after the most powerful sudorifics had been given to no 
purpose. 

5. It sometimes checked the vomiting which occurred in the begin- 
ning of the disease, and it always assisted in preventing the more alarm- 
ing occurrence of that symptom about the fourth and fifth day. 

6. Removed obstruction from the lymphatic system. 

7. Discharged the bile through the bowels as soon and fast as it was 
secreted, and prevented, in most cases, yellowness of the skin (ibid., p. 
243). 

Sympathy. 395 Q ne f the laws of sensation is, that certain impressions which 

excite neither sensation nor motion in the part of the body to which they 
are applied, excite both in another part. Thus worms, which are not 

partluffeS? fel* m the stomach or bowels, often produce a troublesome sensation 
in the throat. . . In like manner the irritants which produce fever, in 
ordinary cases pass through the bloodvessels, and convey their usual 
morbid effects into a remote part of the body, which has been prepared 
to receive them by previous debility (ibid., pp. 60, 61). 

No amount 396. It is not an easy thing to affect life, or even suhsequent health, 
uL p Sh- by copious or frequent purging. Dr. Kirkland (Treatise on Inflamma 
ous. tory Rheumatism, vol. I., p. 407) mentions a remarkable case of a gen- 
tainedby tleiuan who was cured of a rheumatism b y a purge which gave him 
Ss large oetween forty and fifty stools. This patient " had been previously affected 
by his disease sixteen or eighteen weeks." Dr. Mosely not only proves 
the safety, but establishes the efficacy of numerous and copious stools in 
the yellow fever. Dr. Say probably owes his life to three-and-t/went/y 
stools, procured by a dose of calomel and gamboge, taken by my advice. 
Dr. Redman was purged until he fainted by a dose of the same medi- 
cine (ibid., pp. 243, 244). 

Diarrhaa 397 But wao can suppose that a dozen or twentv stools in a day 

never fetus, n t j • A 7 7 

but the dis- could endanger life that has seen a diarrhoea continue for several months, 

the e <5aus C e o? attended with fifteen or twenty stools a day, without making even a mate- 

^heeaT" r ^ breach in the constitution f Hence Dr. Hillary (Diseases of Bar- 



THE DOCTRINE OF PURGATION. 



101 



badoes, p. 212) has justly remarked, that " it rarely or never happens that 
the purging in this disease, though violent, takes the patient off, out the 
fever ami inflammation of the bowels." Dr. Clark (Diseases in Voyages 
to the Hot Climates, vol. II., p. 322) in like manner remarks that evacu- 
ations do not destroy life in the dysentery, but the fever, with the emacia- 
tion and mortification which attend and follow the disease (ibid., p. 245). 

398. I have remarked in the history of this fever that it was often 
cured on the first or second day by a copious sweat. It would be absurd 
to suppose that the miasmata which produced the disease were discharged 
in this manner from the body. The sweat seemed to cure the fever only 
by lessening the quantity of the fluids, and thus gradually removing the 
depression of the system. . . The reason why a few strong purgatives 
cured the disease at its first appearance was, because they abstracted in 
a gradual manner some of the immense portion of stimulus under which 
the arterial system labored, and thus gradually relieved it from its low 
and weakening degrees of depression. . . Bleeding was fatal in these 
cases, probably because it removed this depression in too sudden a man- 
ner (ibid., pp. 277-279). 



Sweats 

(crises) 

and purges. 



Bleeding 
fatal. 



399. Baron Humboldt informed me that Dr. Caristo had assured him 
that bark hastened death in every case in which it was given in the yel- 
low fever of Vera Cruz. If, in any instance, it was inoffensive or did 
service in our fever, I suspect it must have acted upon the bowels as a 
purgative. Dr. Sydenham says that bark cured intermittents by this 
evacuation, and W?n. Bruce says it operated in the same way when it 
cured the bilious fevers at Massuat (ibid., p. 293). 



Bark 

destructive 
except when 

it acts as 
purgative. 



400. The result 



Bark, wiue, 
I and lauda- 
num. 



Clerical evi- 
dence in fa- 
vor of purga- 
tion. 



Whilst Dr. Bush was working from eighteen to twenty hours a day 
healing and saving by hundreds, the old-school physicians, who derided 
his innovations, persisted in the use of bark, wine, and laudanum, and 
thus succeeded in killing their patients ''''secundum artemP 

401. The JRev. Mr. Fleming, one of the ministers of the Catholic 
church, carried the purging powders in his pocket, and gave them to his 
poor parishioners with great success. He informed me that he had ad- 
vised four of our physicians, whom he had met a day or two before, " to 
renounce the pride of science, and to adopt the new mode of practice, 

for that he had witnessed its good effects in many cases" (ibid., p. 314). 

402. Reason and humanity awake from their lone; repose in medi- Rwon and 

, ., . . . . « 7 J _, . ., . .. . • -, ,p x * ,., humanity 

erne, ana mute in proclaiming that it is time to take trie cure ot pestilen- are opposed 
tial epidemics out of the hands of physicians, and to place it into the ^mSjgSvy- 
ha/nds of the pjeople. . . The safety of consigning to the people the cure 
of pestilential fevers, especially the yellow fever and the plague, is 
established by the simplicity and uniformity of their causes and of their 
remedies. 



Popular com 

io pared with 

had no physician recovered from the fever than of those who had the tr^fment. 



403. Dr. Lin/1 has remarked that a greater proportion of sailors wh< 



102 THE DOCTRINE OF PURGATION. 

The worst best medical attendance. The fresh air of the deck of a ship, a purge 
thf^impS of salt water, and the use of cold water, probably triumphed over the 



to cure. 



cordial juleps of the physician (ibid., p. 319). 



°tker medt- 404. For a long while air, water, and even the light of the sun, were 
ues consid- dealt out by physicians to their patients with a sparing hand. They 
the?? hum possessed for several centuries the same monopoly of many artificial 
nou^Qced remedies. But a new order of things is rising in medicine (ibid., p. 
320). It is not more necessary that a patient should be ignorant of the 
medicine he takes, to be cured by it, than the business of government 
should be conducted with secrecy in order to secure obedience to just 
laws. Much less is it necessary that the means of life should be pre- 
scribed in a dead language, or dictated with the solemn pomp of a ne- 
cromancer. The effects of imposture in anything are like the artificial 
health produced by the use of ardent spirits. Its vigor is temporary, 
and is always followed by misery and death (ibid., p. 3 L J1). 

die uno ^^' ^ wcm W as soon believe that ratafia was intended by the author 

nopoiy fur- of nature to be the only drink of man, instead of water, as believe that 

ther consid- ^ Q k now ] e( ]g e () f w h a t relates to the health and lives of a whole city or 

nation should be confined to one, and that a small and privileged order 

of men. But what have physicians, and what have universities and 

medical societies done, after the labor and studio;; of so many centuries, 

Medical ig- towards lessening the mortality of pestilential fevers? They have either 

norance and copied or contradicted each other in all their publications. Plagues and 

contradic- -T,. , ., 1%1 , , , . , l . „ , yO 

tions. malignant levers are still leagued with war and famine m their ravages 
upon human life (ibid., p. 323 ; cf. Asclepiades, 63). 

406. A Mohammedan and a Jew might as well attempt to worship 

why Dr. the Supreme Bein<? in the same temple, and through the medium of the 
Rush would L & i . . ,> l ' ., • • i i 

never "con- same ceremonies, as physicians ot opposite principles and practice at- 

^hebari? tempt to confer about the life of the same patient. What is done in 
wine and iau- consequence of such negotiations (for they are not consultations) is the 
ineffectual result of neutralized opinions; and, wherever they take place, 
should be considered as the effect of a criminal compact between physi- 
cians to assess the property of the patients, by a shameful prostitution 
of the dictates of their consciences. . . 

The extremity of wrong in medicine, as in morals and governments, 
is often a less mischief than that mixture of right and wrong which 
serves, by palliating, to perpetuate the evil (ibid., p. 349). 

407. In one very malignant case the most drastic purgatives brought 
BLAciVlml) away, by fifty evacuations, nothing but natural stools. The purges were 
F Js-^m] continued, and finally black fasces were discharged, which produced im- 
fear'not and me diate relief (ibid., p. 375). « 

408. I observed the same relief from large evacuations of fetid bile in 
This plan the epidemic of 1797 that I have remarked in the fever of 1793. Mr. 

move? debit Bryce has taken notice of the same salutary effects from similar evacua- 

ity; tions in yellow fever on board the Busbridge Indiaman in 1793. "It 

was observable that the more dark colored and fetid such discharges were 

the more early and certainly did the symptoms disappear. Their good 



THE DOCTRINE OF PURGATION. 103 

effects were so instantaneous that I have often seen a man carried upon 
deck, perfectly delirious with subsultus tendinum, and in a state of the 
greatest apparent debility, who, after one or two copious evacuations of 
this kind, has returned of himself, astonished at his newly-acquired 
strength " (Annals of Medicine, p. 123). 



409. Very different are the effects of tonic remedies when given to re- 
move this apparent debility. The clown who supposes the crooked ap- whilst tonic 
pearance of a stick, when thrust into a pail of water", to be real, does not su-oy.^*^ de 
err more against the laws of light than that physician errs against 

a law of the animal economy who mistakes the debility which arises 
from oppression for an exhausted state of the system, and attempts to 
remove it by stimulating medicines (vol. IV., p. 38). 

INTERESTING ARTICLE. 

Baklow, Edward, M. D., Pathological and Practical Observations. 
Path, 1S10. See Edinb. Med. and Surg. Journ., 1814, Vol. X. 

410. Purgatives are of three sorts : some evacuating the fecal con- Purgative* 
tents of the intestines ; others acting on their exhalent arteries, and pro- caY CU maner~ 
ducing copious watery stools — and a third class stimulating the mucous fery^ooit 
follicles which so abundantly line the intestines and causing them to ex P el mu - ' 
expel the mucous matters they so copiously secrete. When the bowels first, m mac- 
are merely inactive, their secretions healthy, and no constitutional disease th«T n bowds, 
present, the simple aperients of the first class suffice to obviate costive- eJjJSjjJJSS. 
ness and prevent feculent accumulations. The second are requisite .second, in 
when, in addition to unloading the intestines, it is desirable to abate Son o/fevet 
internal action or allay fever, by reducing the quantity of the circulating r c ?rc3ng e 
fluid ; and the third are required either when the mucous secretions are S^morbS 
so morbid as to give rise to diseases, or when they are too copiously gen 
erated in consequence of increased action of the vascular system (pp 
431,432). ' F1 

Brandreth's Pills in one medicine accomplish the three indications required. In doses of 
from one to four Pills, they evacuate the fecal contents of the intestines ; from four to six 
they operate upon the exhalent arteries and produce copious watery stools ; in doses of from 
six to ten pills they stimulate the mucous follicles which so abundantly line the intestines, 
causing stools of pure mucous. In headaches, dyspepsia, apoplectic and paralytic symp- 
toms, and in gout and rheumatism, no cure can be obtained without the expulsion of large 
quantities of this mucous, which Brandreth's Pills effect with entire safety. 

411. When it is considered that the diseases of repletion are by far Diseases of 
the most numerous that the human body is liable to; that the alimenta- ^rf^viV 
ry canal affords one of the most important outlets for discharffino; the c ,annot b f 

i j?i_i ± iiy'i-i • • i i' & • & . t dispensed 

reuundancy ot the system ; that it is also a principal one lor getting rid with to re- 
of the excrementitious impurities, with which in such diseases the blood 'Tementf-*' 
is speedily adulterated, and that the diseased secretions which accumu- "^onTthe" 
late within it are oftentimes a means of continuing, of complicating, i>i»wl. 
and even of creating various diseases in different parts of the body, tlie 
value of purgatives cannot fail to be duly appreciated. 

It remains for me to show that such morbid secretions do exist within „ u . 

-i in* • it ii i i«i . Morbid se- 

ttle stomach and intestines, and that they do produce therein the effects cretions in 

now attributed to them, being the direct cause of some local complaint s, ESs^ef 11 

while they beget also, by remote sympathies 5 diseases in distant parts (p. sympathy. 



in morbidity 

or super- 
abundance 
of mucou3 
secretions. 



Examine 
the 



104 THE DOCTRINE OF PURGATION. 

■ 
412. Of the existence of superabundant mucous in the stomach and 
intestines during inflammatory complaints, sufficient proof will be 
oMntesKs afforded merely by inspecting the discharges brought off by particular 
and stomach, evacuants, or occasionally by the natural efforts. With respect to the 
stomach this examination may mislead, if only superficial ; for the 
mucous being clear and colorless, is not readily distinguishable from the 
watery fluid surrounding it ; if, however, a rod or wire is passed through 
the liquor, and elevated, it will raise the mucous existing therein, and 
sufficiently manifest its dense and viscid nature (p. 433). 

J"?™™ 413. It is this mucous that is produced by increased arterial action, 

ud,iih mucous / - y> ._ ii^»i i • 

creates dis- affecting the mucous glands oi t lie stomach in common with all the 



■j;A\;y. 



other parts. To it, and to the action which produces it, superseding the 

healthy action of these parts, do I attribute the incipient nausea of fever 

purgatives anc [ f constitutional inflammation ; and its expulsion I deem important 

tion of the both as removing an injurious accumulation, and as enabling the secret- 

se ex P e iiing in ing vessels, thus disencumbered, to continue those efforts, whose direct 

mucous. tendency is to relieve the general circulation, however inadequate they 

may be, when unassisted, to accomplish this purpose. Similar secretions 

are going forward also at such times throughout the whole course of the 

intestinal canal, and are evidenced by the quantity of mucous which a 

dose of calomel or antimony, administered under such circumstances 

uniformly expels (ibid). 

Howtose- 414. The want of sufficient attention being given to the peculiar 
galivelf-" effcct P ro( luced by different purgatives, may perhaps suffice to account 
whenthemu- for the uncertainty and indecision which still prevail in their employ- 
i ? 8° U of decent ment. If this mucous matter is recently formed, and in no great abund- 
dZmcfmf- ance > a common purgative of the drastic kind will suffice to remove it, 
fi<*i together with all such fecal lodgments as may have taken place in the 

intestines. A source of injurious irritation is thus removed • the various 
secreting and excreting vessels are left free to perform their natural func- 
tions / and the progress of nature, in her force to restore health, goes for- 
when it is of ward uninterruptedly. If the mucous secretions are of older formation 
, pmoet- and consequently more viscid, more tenacious and more difficultly expelled, 
'" the common purgatives fail to give relief, and a doubt is cast on the pro- 
priety of employing them, and on the veracity of previous reports of 
successful cures. The error here, however, is in employing a purgative 
salts me&ec inadequate to producing the effect required. . . . If saline purgatives 
are given with the expectation of cleansing the intestines when loaded 
with mucous secretions, they will very imperfectly effect this purpose 
(pp. 433, 434). 

mS%t™t- 415. The quantity of this mucous secreted in acute diseases is very 

cous from considerable. It lines both the stomach and intestines, and causes many 

e'asesVndcr powerful medicines to pass through them without .producing their ordi- 

of m?Dy a pu° nary effects ; for, in consequence of the interposed mucous, the medic/ ties 

gatives. come only imperfectly or not at all in contact with the living fibre, which 

alone they are capable of stimulating. It passes through, therefore, as 

if either the living fibre were torpid, or the medicine inert, when neither 

supposition is correct / and- to mistake and accident we are occasionally 



tion 

ful purga 



tual. 



THE DOCTRINE OF PURGATION. 105 

indebted for illustration of this subject, which perhaps regular prac- 
tice would more slowly and imperfectly afford us. For the errors of 
dispensers and the stupidity of patients have not unfrequently afforded 
me instances of inordinate doses of purgative medicines being given, 
with only moderate and salutary operation (p. 434). 



Large doses 
often have 

but moder- 
ate opera- 



416. Case of scarlatina given. — Purgatives were, in consequence, Scarlatina. 
thenceforward more freely employed, and the effect regarded more than and noTtfae 
the dose necessary for producing it ; and although the inflammatory considered. 
fever ran high, and was not allayed for many days, there did not occur 
a speck of ulceration on either tonsil. Neither did any of the ordinary 
sequelae attend the disease, but the recovery was progressive and com- 
plete. 

We may hence infer the difficulty of establishing the precise dosea 
of medicines to be admitted, and must be conscious of the superior ad- 
vantage of attending solely to the sensible operation, when this is capable 
of being ascertained, disregarding altogether the quantity of medicine- 
necessary for effecting it. This is always possible with respect to purga- 
tive medicines, and to be accomplished by regular inspection of the alvine inspection 
evacuations, without which the practitioner must remain in much doubt ^^free- 
concerning some of the most important operations going forward within ommended. 
the body, and must labor under great disadvantages in accurately apply- 
ing the remedies it is necessary to employ (p. 435). 



ter in the 
oc- 
casions gas- 
tric dis- 
eases. 
Gastro- 



417. Morbid secretions are very frequently formed in the stom- Morbid mat- 
ach, which occasion a large proportion of gastric diseases. To par- stomach ° 
ticularize only one. Conceiving the pain in gastrodynia to proceed 
from a contractile effort of the stomach to throw off from its surface the 
mucous which offends it, I have for many years laid aside the use of dynia. 
opium and stimulants, which merely repress the effect, without at all re- 
moving the cause, and which even tend to add to this by stimulating the s f^uiantf 
glands to increased secretion of the offending mucous, and have trusted d ° uot ™- 
solely to such medicines as act by expelling that matter, to whose presence cause— pw- 
I attribute the complaint. . . ga ^S%J t ' 

I own I am averse to relieving the pain by opium, or by any means °^ e a D t ^ s 
but a removal of the offending matter — as the relief to pain consequent 
upon such evacuation may be relied on as annmincing the radical care of 
the complaint. In some hundred cases that I have now treated on these 
principles I have in no instance given a grain of opium, or failed in 
giving decided relief iVlmost the only medicine I employ as a purga- 
tive compound consists of extract of colocynth, calomel, and antimonial 
powder (p. 436). 



418. The disease of colic I believe to he, precisely analogous with gas- Goiio-WA 
trodynia, both in its pathology and treatment, and to differ only in being treatment - 
more prone to pass into inflammation. The remote sympathies which 
different parts of the body evince under disordered condition of the 
stomach and digestive organs have often engaged the attention of prac- 
titioners (p. 437). 

419. I have mentioned that in all complaints attended with fever, or conXtion- 
constitutional inflammation, the gastric and intestine secretions arc ^ a ^;H'" u ' 



Morbid se- 
cretions and 



106 THE DOCTEINE OF PURGATION. 

quickly increased. Accumulations of morbid secretions oftentimes take 
place in the alimentary canal, of slow and gradual formation, and not 
increased ar- referable by any well-marked connection to a state of generally increased 
arterial action. The former state may even be superinduced upon the 
latter, and thus an additional complication, both of diseased action and 
of diseased condition, ensue. A disease, in which this morbid state of 
the secretions exerts considerable influence, is rheumatism (ibid.) Cases 

Bheuma- „ -,-, N J 

turn. tollow : 

Gout. 420. Admitting, then, the pathology to be correct which attributes 

Cure°iy' gout to the existence of a state of plethora and inflammation in the blood- 

yurqatwes. ves8e i s ^ anc [ the influence of vitiated secretions within the alimentary 
canal — which latter may be regarded in a great degree as the natural 
product of the former — does it not seem to be fully within our power to 
bring this hitherto intractable disease under the control of rational prac- 
tice ? And may we not hope to treat it as effectually, and much more 
safely, by the well-ascertained powers of such a remedy as a combina- 
tion of colocynth, calomel, and antimony presents us with, as by the less 
manageable means of white hellebore, or the precarious and uncertain 

Coichicwn. « eau medicinale," i. e. % " colchicum f n (P. 441.) 

Applicable to 421. The means I would recommend are advocated not for their 
Bm piiit Ws possessing any secret or unexplained power ov^r disease, but from their 
being pointed out by a rational pathology, and fully established, both with 
respect to their safety and efficacy, by extensive expei-ience (ibid.) 

B. G. B., Observations on the Treatment of the Sick returned from 
Corunna. See Edlnb. Med. and Surg. Journ., 1810, Vol. VI. 

Mvers. 4-22. There appears too great a desire of discovering something like 

M Si™*ir a specific for fever to the very great neglect of obtaining evacuations. 

can never su- -l i i i t • 1 • i • i it 

persede pur- (Jalomel seems to be regarded m this way, and is abundantly employed 

cure^— some 6 - with a view of producing some particular irritation of the system that 

aTapurga- w ^ arrest the progress of or remove the complaint. 

twe. Whatever this medicine may do, after evacuations have been prom- 

ised, I feel certain of one thing, that it will never supersede the neces- 
sity of evacuations in fever ; and I question very much if its good effects 
in fever, and in all inflammatory complaints, do not depend tipou its 
evacuating qualities (p. 170). 

Dr. Freind 423. Those, however, who attempt to cure inflammato7 v y fever, or in- 
on fevers- -flammation. by any other means than by evacuation of some sort or other. 

evacuations J -> v J p J , > 

alone can will lose many an opportumty for doing good j and, m confirmation 01 
^utmTm— this opinion, 1 will quote the authority of the very learned Dr. Freind: 
death. a jj oc umim libi spondeo te experiundo comprobaturum, quod silicet ex 
febribus multsG evacuantibus solis, etiam si haud alio fueris remedio 
usus, cedere consuescant ; vix ullas antem, quae paulo vehementius in- 
valuerint, medicina qualiqunque, si ab hoc evacuandi instituto decesseris, 
restingui possint." (Commentaries on 1st and 3d books Hippocrates.) 
Dr. Freind here observes tluvt many fevers will yield to evacuations 
alone, when no other remedy is used / but scarcely any will be removed, 



Bilimis fe- 
ver. 



THE DOCTRINE OF PURGATION. 107 

when the fever is great , by any remedy whatever, if evacuations are not 
employed. I have no hesitation in saying, when this plan is speedily 
adopted, that the most beneficial effects will generally result, and that 
a great many cases of inflammatory fever which would otherwise have 
ended fatally, or become putrid, and have been protracted for a fort- 
night or three weeks, or even longer, will by this system terminate favor- 
ably in a week (pp. 170, 171). 

Tuomet, Martin, M. D., A Treatise on the Principal Diseases of Dub- 
lin. Dublin, 1810. 

421. Bilious fever. — Purgatives must be steadily persevered in 
throughout the complaint, for it is upon them we must chiefly rely for 
success ; and as the accumulation of foul matters in the alimentary canal 
is constantly and copiously produced, so there is no disease in which the 
free and regular use of purgatives causes less distress or gives more* uni- 
form relief It frequently happens that from the operation of a purga- copious 
tive a large quantity of foul excrements come away ; and yet in ten or ^ a cuaUoL 
twelve hours after there is another large evacuation, so as often to cause ^jjSuJnt 
just surprise how so much could be generated in so short a time ; and induce no 
these copious and foul evacuations continue for several successive days 
without inducing proportionate weakness, but, on the contrary, they 
procure great mitigation of the symptoms. Even delicate and young 
females are relieved, without being exhausted, by these evacuations (p. 8). 

425. So far from producing weakness, we have often observed with Fvaoua . 
pleasure the renewal of strength, which these evacuations occasion, when Hona give 
a languor or depression of the animal powers, even to faintness, had pre- remove de- 
viously existed. But we have likewise remarked that, as soon as the blllty ' 
alvine excretions have assumed a natural appearance, a much smaller 
evacuation has actually produced a considerable reduction of strength 
(p. 9). 



Dark forces 



. 426. It is remarkable that we are disappointed of any substantial 
improvement in the state of our patient whilst the dark f wees remain are critical, 
behind, notwithstanding the quantity of the evacuations procured (ibid). 

BtrcHAN, A. P., M. D., Bisnomia. London, 1811. 



427. Is it credible that a human infant should be so imperfectly or- Chiwwod 
ganized that it cannot pass over the years of childhood, naturally the oaiomO. 
most healthy period of life, except the biliary system be ever and anon 
expurgated by calomel? or that the early and habitual use of this min- 
eral poison can be unattended with injurious consequences? Perhaps 
the time may come, when the most judicious plan of curing^ internal as timelo^ome 
well as external complaints,will be acknowledged to consist in removing 
all impediments to the natural exertions made by the vital energy to re- 
store health (p. 71). 



108 THE DOCTRINE OF PURGATION. 

Clark, Joseph, M. D., On the Bilious Colic and Convulsions of Early 
Infancy. Dublin, 1811. See Transactions of the Royal Irish 
Academy, 1811, Vol. XL 

childhood- 428. In the beginning of my practice, as long as I pursued the beaten 
Co ™bI s aA 8 track of employing mixtures of rhubarb and magnesia, solution of man- 
practice fatal na { n fennel-water, chalk, musk, opium, and blisters, recovery from con- 
the cure, pulsions in early infancy was a rare occurrence. After six years' close 
attention to the subject I am convinced that in colic and convulsions 
nothing but a brisk expulsion of the contents of the bowels is likely to 
afford permanent relief. A dose or two of castor-oil, or a common pur- 
gative enema, may remove slight attacks of this nature. It is in general 
after the failure of such measures that a physician's advice is required 
(p. 124). 

Hons—i astke ^29. The purgation must be very active and continuous to be efficient. 

quantity so I n the course of recovery the quantity of evacuation seldom fails to as- 
tonish the attendants, who cannot well comprehend whence it all can be 
derived. The relief obtained is uniformly proportioned to ths quantity 
discharged (ibid.) 

Armstrong, John, M. D. Observations on tlie Origin, Nature and 
Treatment of Tyvhus Fever — m Medical Intelligencer, 1812. 

Man^oT'its 430. The want of due decarbonization of the blood is the cause of 

symptoms many of the most remarkable symptoms attendant on typhus. Blood 

™Z^rhon^ not duly decarbonized, operates more or less as a narcotic on the brain, 

Mood. OJil>e an d tends materially to influence the animal heat and the heart's action ; 

and hence partly arise the muddled shite of the brain, the smothered Jieat 

of the surface, and the soft, compressible pulse, &c. Why typhus-fever 

intermittent assumes in one person an intermittent, and in another the remittent or 

0T }o™n— nt continued form, is most probably owing to the dose of the poison, or the 

causes of. condition of the recipient, or both conjoined (Med. Int., No. 30, May, 

1812).* 

Tlie Morbid Anatomy of the Bowels* Liver and Stomach. London, 1828. 

Smaii-pon, 431. Tlie contagions of small-pox, measles and scarlatina first ope- 

rate on the blood, and that fluid being thereby changed, the solids are 
specifically affected, especially the skin and mucous membranes of the 
air-passages ; and these affections, too, if left to themselves, and even 
Nature com- often in despite of medical applications, have a determinate course, the 
tiuai e flowin g blood apparently, like the water of the Thames, requiring a certain lime 
river. y or fa purification, which it effects, perhaps, by throwing off the effete and 
superfluous matters, through the secretions and excretions (Art. I, p. 10). 

Letter to Dr. Boot, contained in Dr. Boot's edition of Armstrong's Works. 

Much learn- 132. I have never yet met with a learned physician who was a good 
fSfiyfn e prac- practitioner. At the bedside such men are lost in the conflict of au- 

tical matters, thority. 



measles, 

scarlatina 

— ?>lood-dis- 

eases. 



THE DOCTRINE OF PURGATION. 



109 



Hartz, William, M. T>. On the use of Purgatives in Purpura. 
Dublin. 1813. See Ediotb. Surg, and Med. Journ., Vol. IX. 



433. Purpura. — Convinced by my previous ill success of tne ineffi- 
cacy of mere tonics in bad cases, and favorably impressed by the occur- 
rence of cholera previous to the appearance of the petechia?, I determined 
in this case to direct my whole attention to the state of the abdominal 
viscera, and accordingly prescribed brisk purgatives. From the good 
effects of the first, I directed its repetition for a few successive nights. 
To my surprise the hemorrhage soon ceased, the spots rapidly disap- 
peared, and in less than ten days the patient recovered, under every 
possible disadvantage of constitution, of air, and of diet. Encouraged 
by the unexpected result of this unpromising case, I no longer hesitated 
in employing purgatives, and trusting to them only in both species of the 
complaint. It was often necessary, however, to purge to a great extent 
(p. 186). 



Purpura— 
the regular 
practice un- 
successful — 
purgation 

cures. 

Important 

case. 



Full and free 
purgation re- 
quired. 



4:34. It appears from the observations of Burserius, that Strach sup- 
poses petechias, to originate/Wwi vitiated bile in the prima} vice, and from 
a tenacious mucus adhering to the intestines, * and that he accordingly 
proposed strong cathartics as the proper remedy for the disease. . I have 
carried this theory farther, and have, not without advantage, allowed it 
to influence my practice in typhus, when petechias are present, and many 
very desperate cases have appeared to me to owe their recovery, almost 
from the jaws of death, to tJie powerful and repeated interposition of 
purgatives (p. 187). 



Typhus. 

Petechias 

from vitiated 

bile. 



Medicus. 
Vol. XL 



On Pathology. — See Edinb. Med. & Surg. Jour. 1815. 



435. Disordered actions of the human body arc, generally speaking, 
the means which nature employs for the expulsion or removal of offend- 
ing agents ; thus if the stomach be excited to vomit, the cause producing 
that disturbance is removed by that action ; thus also diarrhmas carry 
off noxious matters ; and the emunctories of the body are generally 
cleared out for the same purpose (p. 335). ■ As a machine, the human 
body may be said to " go,^ at the same time that it includes powers 
for repairing all injuries that otherwise would prevent its going, and 
these reparatory processes include almost all the symptoms of disease 
(p. 336). 



Natural 
cure by vom- 
iting, diar- 
rhoea, etc. 



436. We will suppose, for example, that the stomach, unable to per- 
form healthy digestion, presents to the liver, as it passes to the duodenum, 

;m ill-concocted chyme or chyle. Does it nut become necessary thai the 
liver should pour forth a bile suited to the purpose it has to answer I 
a purpose far different from what would be required if a healthful 
digestion had taken place in the stomach. Such a bile cannot be deemed 
improper, since it answers the purpose for which it was intended, name 
•f carrying through the bowels what was noxious, -and of effectually 



Thculnniach 

— vicarious 

function of 

the liver. 



110 THE DOCTRINE OF PURGATION. 

assisting in assimilating such parts as are healthy and proper. To attack 

the liver, therefore, because it has done its duty, would be adding to the 

Mi faSic^ ev ^ s wn ^ cn already excited its powers, and would be exhausting those 

checking the means of resistance and reaction which were appointed for the most 

functfon°pro- benelicent of purposes. To oblige, by medicine, the stomach to retain 

tompiaZT' SUC ^ substances as, in a state undisturbed by medicine, it would reject, 

is the readiest conceivable method of calling forth the symptoms of " liver 

affection" and a general disturbance of the alimentary functions. And 

thus it happens that the more extended reactions of the constitution follow 

these circumstances, and thus, by a very easy process of reasoning, shall 

we arrive at those causes which produce gout, asthma, cutaneous diseases, 

and in short a long train of grievous maladies (p. 336.) 



Purgatives 



437. During healthful digestion, feelings are excited far different 
from those which arise when the meal has not been regulated by mode- 

re!tore ca ration and sobriety ; and how often are means applied to appease the 
he ges h t[on. dl " tumult occasioned at such times, and thus so many noxious agents are 
introduced, which become all the causes of great and extended future 
mischief (p. 337). 

438. It has been said that foulness of the bowels is a common cause 
a^botoeis— of disease. It appears to me that when the bcnvels 2>roduce the foulness, 
curative. so ft en observed, such fotdness proves curative. It is a reaction of the 

liver (?) against a constitutional disturbance, which in the end proves 
curative. Immediately on discovering this foulness, we feel satisfied that 
on its removal the various symptoms of disease will disappear (p. 339). 

439. There is a balance in the constitution consistent with every nat- 
tending *tT ural effort ; it may be called the diathesis, such as gout, and a variety of 
the a cons°tuS- other inflammatory affections, and these states of balance involve their 
tion. own series of phenomena. Thus the head may be oppressed with a super- 
abundance of blood, and may be liable to affections under one form or 
series ; another may involve rheumatism ; another, gout, &c. ; and all of 
them, extended reactions of the system, tending towards a reparation of 
the constitution. 

It may be observed that foulness of the bowels cannot exist to the 
full extent at which it appears at any one period ; for the quantity that 
on some occasions is discharged would be more than the canal was capa- 
ble of containing. It must, therefore, be the result of successive deposi- 
tions from some great secreting organs. For instance, during the exist- 
ence of disease, wherein there are great determinations of blood, ape- 
rient medicines bring away evacuations of no particular character; but 
after a little time the circumstances of the case alter y heavy, lumpy, and' 
discolored evacuations begin to appear, and contin ue to be parted with. 
As soon as these appearances arise, the symptoms of the original disorder 
begin to diminish, and, in the course of a short time, disappear altogether. 
It must have occurred to every practitioner who has strictly examined 
these circumstances, that he has found a difficulty in accounting for the 
quality and extent of this collection of foulness (p. 339). 



THE DOCTRINE OF PURGATION. Ill 

440. It must also have been frequently observed that affections of fSid h e lat 
the head, epilepsy, chorea, local diseases of various kinds, and great and br 7 "ak°tbe 
extended affections of the shin, have all given tody as soon as the vowels power of ais- 
have expelled a quantity of foul and fetid evacuation. During the ^ce^eSc?" 
progress, however, of these maladies, the bowels have not shown the same tIons " 
character until the disorders have attained a particular stage, and then 

the progress towards health is decided. Could we succeed in bringing 
about this stage, many very grievous maladies might be cured ; that is, 
we might induce thereby the various organs of the alimentary canal to 
render the more extended reaction of the system unnecessary. I do not 
mean to deny that there is occasionally a very great accumulation in the 
bowels, so foul a state of them that toorms occur, wdxieli appear there to worms. 
have found a proper nidus ; and that other great sympathetic affections 
take place arising from these accumulations (ibid). 

441. If we trace these affections, we shall find many natural efforts The natural 
made to remove such accumulations and foulness ; and even that many ^nT7e di c- 
very distant reactions occur tending to relieve the body of the griev- tion. 
ance. Thus the blood returning through the " venaportw," is delayed, 

and as the heart acts uniformly, more blood flows to the head than usu- T ^t^^~ 
ally, in consequence of this remora in the return of blood from the 
lower circulation. This fullness of blood in the head, occasions many 
reactions, amongst which we may rank epilepsy, which shakes the whole Epilepsy. 
body in convulsions, and is the means of removing worms and other foul- 
ness from the bowels, as under the influence of that disorder the alvine 
and urinary excretions are violently expelled (pp. 338, 339). 

442. Why disease and cure are units, physiologically accounted for. IMm<m JJJJ* 
— The tendency of disease is either to spontaneous cure or to the extinc- 
tion of life (p. 340). 



The stomach 
— its inti- 



443. The human stomach is an organ endowed by nature with the 
most complex properties of any in the body, and forming a centre of mate relation 
sympathy between our corporal and mental parts of more exquisite whole body. 
qualifications than even the brain itself. Yet the knife and eye of the 
anatomist do not discover the whole importance of the station it holds sympathy 
m the economy. We must look to the living system tor those nice con- trough 
nections of cause and effect, and that source of association which gives organ/suaer 
it a relation to so many organs, both in the healthy and disordered state. on e or may th bi 
.... We find all those viscera which assist in preparing the chyle and the saved - 
assimilation of food, joined in a circle of nervous communication of 

which the stomach is the centre. One portion of nerves is distributed 
over the whole, so that, while they are employed in one purpose, disor- 
der cannot take place in any one of them without the whole being 
thrown into confusion. These associated organs are regulated in their 
apparently disturbed state by laws tending to the relief of that pertur- 
bation. By these associated powers the causes of perturbation are 
removed, and the effects of such reaction are eventually rendered harm- 
less. (Condensed from pp. 345 to ult.) 

444. The nerves of the stomach are connected, through the great sym- Lungs, heart, 
pathetic nerve, with almost every other nerve in the body. The lungs, ntrvov^re- 



112 



THE DOCTRINE OF PURGATION. 



lation with heart, and diaphragm, are also furnished with nerves which communi- 

the stomach, ' Jl o? . . m . . • , 1 i t i i • 

and act with cate with the great sympathetic, liiis nerve is the grand link or chain 
raMm pro- which connects the vital, animal, and natural functions with each other, 
is^emovairf % ^ s no ver V difficult matter to trace the curative actions that take place 
noxious and i n consequence of this nervous connection — how the heart may vary its 
pulsations agreeably to the impulse it receives through this nerve ; how 
the liver and intestines are apprised of the necessity of varied exertions, 
agreeably to the kind of digestion that is to pass the sphere of their du- 
ties, &c. ; all, I say, for the beneficent purpose of ultimately removing 
from the system the noxious influence of offending agents, such influ- 
ence as, were it not for those wise provisions of nature, would prove 
destructive to the human frame (ibid). 



offending 
agents. 



More of this 
" curative 
process." 
If the stom- 
ach is unfit 
to effect this 
cure, excite 
with purga- 
tives. 



445. These several reactions of the body seem all calculated to 
become effectual, when the system ■ is in a state agreeable to the laws 
of nature. A really curative process may be so far altered in its ulti- 
mate results by improper habits of life, that it may not be enabled to 
answer the purpose intended, or it may run into an excess, and even 
occasion detriment to the subject (ibid). 



The " cura- 
tive process" 
— conclu- 



4:4:6. We now see why the operations of the stomach, liver, and 
bowels are so effectual in removing very great and extended disorders 
of the system ; and why, when required, such medicines as call forth 
these reactions of tlie stomach andprimce vice, are the true means of cure. 
So that, whether a disorder originates in the stomach, proceeds to distant 
organs through the stomach, or is a disease arising primarily in a distant 
part of the frame — still such reactions are capable of affording relief 
(ibid., p. 345, sq., cf.). 



Pritchard, J. C, M. D. Remarks on the Treatment of Epilepsy and 
some other Nervous Diseases. See Med. and Phys. Journ., 1815, 
Vol. XL 



Nervous 

diseases — 

cure by %>ur- 

gativeSi 



447. I consider the introduction of the free use of evacuating reme- 
dies into the treatment of nervous diseases as one of the greatest im- 
provements of the medical art which has taken place of late years. 
Imperfect as our knowledge confessedly is with respect to the pathology 
of nervous diseases, and inadequate as our remedies frequently prove 
themselves to be, we have yet the satisfaction of perceiving that we are 
evidently in the right path ; and that, when we have not the means of 
cure in our power, we can at least often palliate, without incurring the 



Epilepsy, risk of making matters worse 
cures of epilepsy given. 



than we found them (p. 459). — Cases of 



Neurosis. 



Mania. 



448. I have tried the use of evacuant remedies in several other dis- 
orders of the class neurosis with success / but in none with more singu- 
lar advantage than in mania, in which distemper I have had extensive 
opportunities of witnessing their effects, having been for some years one 
of the physicians to a hospital where a great number of lunatics were 
admitted. I am firmly persuaded that if medical practitioners would 
depend more on physical and less on moral remedies, they would succeed 



THE DOCTRINE OF PURGATION. 



113 



a greater proportion of cases, especially recent ones, than generally 
happens (p. 456). 



m 



449. Indications to be obtained by the use of purgatives are : 

1. By removing sordes from the intestinal canal. indications 

I am every day surprised at the prodigious accumulation of iu!L ga ' 
fecal matters which I find to take place in the intestinal canals 
of patients of all years. 

2. As depleting the system. 

3. As determining the fluids from the head. 

4. As setting up a new action in the system. 

5. Purging is a powerful means of stimulating the absorbent sys- 

tem, as we witness its effects on dropsical patients. 

6. A course of moderate purgation is one of the most efficient 

methods of invigorating the digestive organs, improving appe- 
tite, and removing visceral obstructions (p. 466). 

Dickson, D. J. H., M. D., Superintending Physician to the Russian 
Fleet. On the Utility of Depletion in a Fever among the Russian 
Sailors. See Edinb. Med. and. Surg. Journ., 1816, Vol. XII. 



450. It is now well understood that the value of purgatives is not 
limited to the mere removal of the fecal contents of the bowels, but that 
they may be so managed as to obviate or relieve a tendency to topical 
congestions elsewhere, and also to produce a considerable effect upon the 
general system, by the increased quantity of fluids they cause the various 
glands and exhalent arteries to pour into the intestines. Thus they be- 
come more universally useful in diseases in general, in proportion as 
they are more uniformly applicable. . . . They were here considered 
not only indispensably requisite in the first instance, and assisted by 
enemas, when necessary ; but they were liberally exhibited throughout 
the disease ; and very often the bowels could not be kept sufficiently 
active unless they were repeated day after day (p. 175). 

451. Though not a new, it is a very important observation, that all 
uncertainty as to their full operation can only be removed by inspection, 
without which the practitioner is very apt to be led to imagine by the 
patient from his own report, or that of the nurse, that he has been suffi- 
ciently purged, when, at most, he may have had only two or three par- 
tial scanty dejections. . . While we are producing foul, dark, fetid 
evacuations, we may naturally expect that we are benefiting and relieving 
the patient. By those that have not had much acquaintance with fevers 
it is hardly possible to calculate the quantity of medicine sometimes re- 
quired to overcome t?te torpor of the intestinal canal, the morbid accumu- 
lations that have been discharged after repeated purgations, and in some 
cases the speediness of their reproduction (p. 175). 

452. In tropical fevers especially, I have seen very striking exam- 
ples of the abatement of fever and delirium after the operation of pur- 
gatwes, and it is therefore of great consequence to be aware that the 
febrile symptoms are often maintained or renewed by the retention of 



Purgatives 
— their value 
unlimited. 



Action on 
glands and 
evhalent ar- 
teries. 



Inspect the 
evacuation 
in order to 
exact suffi- 
cient pur- 
gation. 



Tropical 

fevers. 



114 



THE DOCTRINE OF PURGATION. 



Purges vitiated secretions, or other morbid contents of the intestines, as also of 

tkmed 6 untii the quantity of dark-colored offensive matter that is often discharged 

natural after the patient has been, thought sufficiently purged, and its speedy ac- 

stools ensue. *> 7 ,• • • i , a.* 1 r\ L . L -i • i ^ 

cumulation %n some cases, in order to estimate the extent to which it may 
be necessary to persist in the use of evacuations (p. 176). 

Naval Surgeon. Medical Tocography of New Orleans-, with an 
account of the principal diseases that affected our Fleet and Army 
on the last Expedition against that City. See Edinb. Med. & Surg. 
Journ., 1816, Vol. Xll 



Dysentery— 

its origin 

from the 

liver. 

Morbid mat- 
ters the 
cause which 
must be re- 
moved. They 
injure the 
fabric of the 



cause flux, 
ulcerations, 
etfc. 



453. Dysentery. — In short, to give a condensed view of the whole 
matter, the phenomena of the cases that recovered, as well as the mor- 
bid appearances of those that died, impressed upon my mind a convic- 
tion that the diseased condition of the liver was the soil from which 
dysentery drew its malignant growth, strength, and nurture. This was 
the " fons et origo mali," by it the dysentery was excited, and only by 
its removal could the disease be removed. 1 can readily conceive that 
from the disease of any gland, the fluid it secretes may acquire acrimo- 
nious properties suflicient to injure the fabric of the passages through 
which it is destined to pass. 

We generally observe in dyspeptic complaints, or after a period of 
constipation, when the bile, from remora in the bowels, becomes morbid 
in quantity or quality, either that spontaneous diarrhoea comes on, or, 
after a brisk cathartic has been exhibited, that the dislodged bile excites 
a sensation in the rectum, as if boiling lead were voided. When the 
state of the liver is still more morbid, may not the bile acquire the 
property of exciting flux, and of excoriating and ulcerating the villous 
coat of the colon and rectum f (Pp. 142, 143.) 



Typhus and 
the bugbear 
" debilty." 
Calomei and 
James' pow- 
der. 



Neglect of 
evacuation 
— its conse- 
quence in ty- 
phus. 

Bark, wine, 
opium. 



454. The imaginations of professional men in tropical climates were 
formerly held in subjection by that bugbear, debility, and its train of 
needless horrors. Systems of nosology had been pleased to style the dis- 
order " typhus icterodes ; " consequently active depletion was carefully 
shunned. The practitioner stood fidgeting with his calomel and his 
James' powder. The disease took its hue from the species of treatment 
employed at first. The neglect of evacuation allowed the excitement 
to riot and revel unchecked; hence came petechial, hemorrhages, &c. . . 
Then indeed the disease was pronounced " malignant, pestilent, and 
highly putrescent," and the golden opportunity occurred for throwing 
in — as the phase is — his bark, his wine, and his opium against that de- 
bility, about which at a wrong time he was over-solicitous. That caba- 
listical word " typhus," I verily believe, has slain its thousands and its 
tens of thousands (pp. 147, 148). 



Dropes, Richard L., Surg., Remarks on some Remedies which are Used 
in levers. london, 1817. See Edinb. Med. and Surg. Journ., 
1817, Vol. XIII 



Fevers.— 455. Fevers. — Emetics, I am convinced from experience, have most 

oSapilVet- frequently proved injurious, and have seldom failed to aggravate the 

ice,&n&pur- sum pf; 0ms m a very obvious manner. The great concussion they give 



THE DOCTRINE OF PURGATION. 115 

the whole system, particularly the brain, almost invariably increased the %£il escom ' 
violent pain so often felt in the head, and especially over the eyeballs; thesuprem- 
and this, it is to be presumed, by increasing the morbid action of the latter main- 
vessels of the encephalon. The only cases in which emetics are admissi- ^ed. and 
Me are those in- which an obstinate vomiting takes place, owing to some 
crudities in the stomach, which require to be evacuated (p. 59). 

456. Diaphoretics. — I believe that it is on the principle of the heat sudoriflcs 
of the body being morbidly increased, owing to obstructed perspiration, rfoS'andby 
that sudoriflcs are prescribed for the purpose of removing this obstruc- no means apt 
tion, and lowering the temperature. However, I conceive this practice a°cuJe S ° 
is not well founded. Diaphoretics, before they can have the desired 

effect, almost always increase the morbid action, and most obviously have 
an injurious tendency. Besides, we have other means of lessening vas- 
cular action and reducing morbid heat without being attended with the 
same inconvenience as sudoriflcs. Every day we see patients attacked 
with fever completely recover without there being the smallest tendency 
to a diaphoresis through its whole course. When these medicines have 
been chiefly relied on, I have always observed the disease to be much pro- 
tracted, and the cure extremely tedious (p. 60). 

457. Purgatives. — The generality of physicians place too little de- th^oX^i? 
pendence on these, and trust too much to other remedies. I know of no awe remedy, 
general means attended with so much success as the liberal employment in large 
of cathartics. They should be given in large doses, and often repeated, repeated!* 4611 
till the patient becomes convalescent, which is generally in a few days 

from their first employment (ibid.) 

458. When given merely as aperients their effects are only trifling; A p er ientand 
but when administered with sufficient freedom, with a determination of £"H purga- 

.7 •«* / y. /», , . 7 • tlve action 

reducing inflammation, their curatwe powers are ojten astonishing contrasted. 
(P- 61). 

Wilson, Andrew, M. D., Practical Observations on the Action of Mor- 
bid Sympathies. Edinburgh, 1818. 

459. Nerves possess muscular fibers and blood-vessels, and are subject mrvms 
to foreign influences ; and the condition of the blood must influence their fromtmpure 
actions by influencing their secretion (text condensed from pp. 20, 21, blood - 
and 82). 

460. There is no department of the nervous system by which, if cer- Sympathy 
tain or peculiar irritating causes are applied, some other department of ° 

the same system may not be influenced, so as to draw the organ to which 
they belong into morbid action by sympathetic affinity (pp. 165, 166). 

461. Certain acrimonious matters applied to the extremities of the mr £^ in 
gastric and alvine nerves gwe a variety of deranged actions of the brain, ^ stomach 
although otherwise in a sound state, and the accelerated pulse of the ders of 8 °the 
whole arterial system, from inflammation found in a small portion of its U re 3 %to rict " 
capillary branches, is at once perceptible both to the eye and touch. . . 



116 



THE DOCTRINE OF PURGATION. 



Gastric irritation gives spasmodic affections of the bladder and kid- 
neys. . . Irritation of the lower extremities will excite nausea and vom- 



iting (pp. 166, 167). 



The body a 462. Of all the organs of the human body the gastric and alvine de- 
bid^Srs partment is that which is most extensively and constantly exposed to the 
derange any action of these causes ; a surface which extends from the cardia to the 
pa?t of ve tL rectum, every part of which is provided with nerves of the greatest sen- 
body - sibility (pp. 167, 168). 



Fever— its 



463. Fever is excited by acrimonious irritation in the alimentary 
canal, or by the increased secretions which take place in the liver and 
other abdominal glands (p. 19). 



Heart-Ms- 

from 



as 



organs. 



464. The natural and healthy action of the heart and the whole vas 

tue e digestiv« cular system is impaired and reduced below its natural standard, &i 

exhibited in palpitations, languid pulse, torpor of the limbs, syncope, and 

even death itself, in consequence of the mere application of a peculiar 

offensive substance to the digestive organs (p. 19). 

This paragraph applies to and explains the action of poisons. 



Typhus and 

yellow-feoer 
caused by 
infection act- 
ing on 
impurities. 



Purge xoith- 
out delay. 



465. The approach of typhus and yellow fever is at all times attended 
by decided symptoms of an existing diseased state of the stomach and 
bowels, i. e., with those signs which are known to point out their con- 
tents to be of a morbid, irritating nature ; but whenever the alimentary 
canal happens to be loaded with irritating matter, some derangement of 
the healthy operation, either of the general system or of some particular 
organ of the body, is the certain result ; and when this state happens to 
be united with any other cause of fever (as infections), its effects are 
always thereby much aggravated. It is therefore reasonable to use 
every exertion in such cases to expel it as quickly as possible (pp. 107, 
108). 



Malignant 
fevers. 



Experience from experience as the most advantageous is by discharging fror> 
3ache3/^r- p r i mC B vio3, as expeditiously as possible, their irritating and offe 



466. The method which the most eminent practitioners have adopted 

7 rom the 
__ ? ensive 
copious de- contents, and in reducing the febrile heat by cold applications (p. 128). 
^cate^cure It is also worthy of remark, as it further demonstrates the agei>cy of 

by removing t j ie con tents of the stomach and intestines, in producing organic inflam- 

a superven- . . 7 • i r n 777 

ing cause of mation, that in these cases which terminate most favorably the stools are 
all along abundant and bilious, with some occasional bilious vomiting ; 
and that by these free discharges, the intestinal contents being carried 
out of the body as they are collected, their agency as a supervening 
cause of the febrile state is greatly removed, and they are not left to ac- 
quire that degree of acrimony which is necessary to the establishment of 
inflammation (pp. 129, 130). 



467. A powerful morbid sympathy is called into action (in acute 
rheumatism), and becomes established betwixt the irritated digestive 
iv^orgS' organs and the ligaments of the joints ; the adjoining tendonous expan- 



Acute rheu- 
matism " a 
result of irri 



primary 
cause is re- 
moved. 



THE DOCTRINE OF PURGATION. 117 

sions, the membrane of the muscles, and occasionally the muscles them- Paina con- 
selves, often forming organic obstructions, and exhibiting all the severe thT e 
phenomena of acute rheumatism (p. 210). . . The primary cause in the 
digestive organs is entirely overlooked, and so is left to continue its 
action with full vigor ; consequently the daily repetition of the spas- 
modic paroxj T sm depending upon it, keeps up the local inflammation on 
the sympathizing membranes, and often extends it (p. 220). 

46S. These shiftings of the pains, and change of place from one part Atomcrheu- 
of the body to another, depend on the occasional change of place of the Pain^Xift, 
irritating matter contained in the intestines, to one with which some J? d tlie J? or " 
other distinct part of the body has a more direct sympathetic affinity change their 
than that which the pam has left (p. 249). 



location. 



469. The character of atonic rheumatism consists in a painful aifec- rh ^^u sm 
tion of some muscular parts, or of their membranes. The pains are not —its charac- 
90 severe as in acute rheumatism; they very frequently wander from 

one part of the body to another, although it often happens that they re- 
main fixed in one part for a long time. . . A particular muscle, or a 
portion of its fibers, become frequently so affected by the sympathetic 
spasm as to be impeded in its free action ; the pain being constantly 
aggravated by the slightest movement of the part, although quite easy 
when the muscle is at rest (p. 247). 

470. The remote cause of these phenomena is decidedly seated in the Tb f 1 c 'J: h ^ of 
digestive organs in atonic as well as in acute rheumatism. They are in matic com- 
their nature spasmodic, only the seat of the morbid sympathy most com- p Jhe D «%!s«J- n 
monly appears to be one less susceptible of that inflammation which iV6 or, ^ns. 
forms the secondary disease of acute rheumatism (p. 248). 

471. In the treatment of acute rheumatism muoh attention is due to th g Ja'SthI 
the state and circumstances attending the primary gastric fever. Expe- rnostfrea 

, .. . . S ' • 7 • evacuation 

rience has supported the opinion that, in proportion as the primary is required, 
cause of disease is removed, the sympathetic effect on the membranes of 
the joints begins also to subside (p. 221). In order to accomplish this 
object the most free evacuations from the stomach and intestines are re- 
quired, and the patient generally bears them well (p. 222). 

472. But of a much more painful nature than the atonic rheumatism . Lumia^, 

-, n 7 7 .. L . 7 7 ■. .7.7. nip ihxeaxe, 

are the cases 01 Lumbago, sciatica, tic douloureux, and periodical or inter- ami uc-dim- 
mitting rheumatism. They are with great certainty to be traced from from dST' 
the same remote cause, and, like the former, are only sometimes attended mlntary 
with gastric fever, but are uniformly associated with decided signs of a nal 
diseased state of the alimentary canal (p. 249). 

473. All local applications, independent of clearing the alimentary fijgagSJ 
canal from its contained acrimony, can go no further than merely to pal- °n'y paiu- 
liate the effect of this cause, but without curing the disease, which will cause" must 
not happen while the power of the other remains in action (p. 257). Jj c ;?™ oved 



laease 
of the all- 



118 THE DOCTRINE OF PURGATION. 

Erysipelas. 474. Erysipelas is intimately connected with the state of the diges- 
removing tive organs, which is clearly demonstrated by the well-known fact of its 

th caus°e bld appearing in various degrees on the skin, in consequence of certain kinds 
of food having teen taken into the stomach, and this not only in too 
short a space of time after to admit of the chyle impregnated by them 
to be taken into the circulation, but while they as yet remained in the 
stomach, and the inflammation disappearing as soon as those contents 
were thrown off (p. 371). 

Sore-throat 475. From the great similarity of the general symptoms exhibited in 
l fJer a Som scarlet fever to those exhibited in typhus fever, it will be obvious that 
stomach- the treatment here ought to be very similar to that adopted to those 
vapors. • an ^ er typhus ; which is, in the first place, pointed to the mitigation of 
the two great supervening causes of fever — irritation in the primce, vim 
and excess of caloric — especially to that which is seated within the diges- 
tive organs ; the very exhalations from which, ascending to the fauces, 
do, beyond a doubt, tend to keep up the inflammation, and, consequently, 
the ulcerated state (pp. 142, 143). 

rurgaUon 476. That free evacuations increase debility is in reality an un- 
binty? 53 and foimded apprehension. . , Whatever will act upon the morbid cause, so 

strength as ^- evacua te it from the body, so far from weakening, will assuredly 
tend to restoration of the strength • and this is a fact which unvarying 
experience has proved in every instance where nature has not been 
already exhausted by other means (pp. 60, 61). 

The advan- 477. The intention is not merely to preserve the bowels soft, but to 
pSrgaUm! discharge from the intestines a lurking cause of disease ; to accomplish 
which purpose very full evacuations are always necessary, procured by 
Examina- the help of the most active purgatives administered in appropriate doses ; 
jections. " remarking the nature of what comes off till it puts on a healthy ap- 
pearance (p. 62). 

impurities 478. To restore health, purgatives must be perseveringly applied (in 

imping tyP nus fever), as it is certain that the retention of any sort of noxious 

than the matter in the primce vim, the tendency of which is in general to lessen 

u gation pur " the energy of the nervous system, is infinitely more debilitating to the 

human frame than the temporary fatigue attendant on the moderate 

operation either of an emetic or purgative medicine, besides the harm 

which may ensue from the noxious matters being partially reabsorbed 

(pp. 110, 111). 

ifeaste*. 479. That a state of morbid sympathy betwixt the stomach and 

between 7 lungs does actually exist in many cases of measles I believe to be cer- 

8t iSn^-^ d tain. My belief is founded on the very great relief from pneumonic 

purge' the symptoms received by a free discharge of acrid matter from the stomach 

acrid mat* J .£, . i • /v i • i -\ " i n p it 

ters away, and intestines — a reliei wmcli can be accounted tor trom no other law 

of the animal economy. Repeated bleedings will, no doubt, tend to 

me and ng lessen the vascular action, but probably in no high degree, while the 

miidpurga- secondary cause of fever continues to give its irritation to the nerves of 

useies^and the stomach and bowels ; and it is obvious that venesection cannot act as 

why * a means of removing this cause, neither, indeed, are the more lenient 



THE DOCTRINE OF PURGATION, 119 

cathartics to be depended on for this purpose ; for although they will to 
a certainty open the bowels, yet they very frequently pass along and leave 
the offending cause behind. It is the more active powers of drastic pur- 
gatives alone which are here to be confided in (pp. 136, 137). 

Hamilton, Jr., John. On the Use and Abuse of Mercurial Remedies. 
Edinburgh, 1819. 

480. In pleurisy, from the time that the influence of mercury be- Pleurisy— 
comes evident, the general strength rapidly declines (p. 7). eKf 1 ^ 

mercury. 

4:81. If there be ulcerations in any part of the body, they must as uicers— 

certainly degenerate into malignant sores, under the influence of mer- S^Unt by 

cury, as* blistered surfaces or scarifications mortify in cases where the m6rour v> 
living powers are much exhausted (p. 9). 

Johnson, James, M. D. Critical and Explanatory Remarks in his 
Periodical, Medico-Chiruegical Review, established in 1819. 

482. Purgatives in intestinal inflammation have been objected to intestinal 
on the ground that they are quickly rejected by vomiting ; but this ob- %nfl uoT a ~ 
jection is not valid. . . If the first purgative be rejected, it is repeated G t iv| a unuf" 
by Dr. Pring in an hour or two, and so on, with various forms of pur- the .stomach 
gatives, until the bowels are opened, when in general we find the ball and the cure 
at our own feet (vol. IV., 1823, p. 259). is effected - 



483. Dr. Pring says, " typhus has two origins, one from external Typhus— 
affection, and the other from a spontaneous generation of disease in the. lts ongin * 
subject affected by it " (ibid., p. 250). 

484. His favorite practice is purgation of a very active kind (Pr., p. {r f pop ^ xy 
102) ; has seen his patients stimulated into fatal apoplexy (ibid., p. lants. 
251). 



485. In the treatment of any form of chronic disease, whether in chronic dis- 
the digestive organs or elsewhere, purgatives frequently increase the JfeVt'o/ 
symptoms at first, an effect which is rather desirable than otherwise, 8 Cifng™the 
and it proves that the remedy has a relation with the disease, and is , remed y *> 

i i j» i • i • • n • -in /y> • i 7/» have a rela- 

capable ot subverting this state, ij continued j or a sufficient length of «©» with the 
time (ibid., p. 275). • dlsoase - 

By the use of Brandreth's Pills the vital forces change chronic affections into acute. Then 
further purgation with them soon effects a cure. 

486. Dr. Abercrombie is of opinion that the only remedies of real ^p 1 ' 16 ?*?: 
efficacy in epilepsy are purgatives and a strict vegetable diet, with total purgative*. 
abstinence from strong liquors (ibid., pp. 127, 128). 

487. Constipation in Pregnancy. — De Lemazurien was sent for on constipa- 
the 8th of July, 1823, to see a woman in the seventh month of her 
pregnancy. Abdomen much distended, transverse arch of the colon 



120 THE DOCTRINE OF PURGATION. 

greatly distended, pulse and appetite feeble, dyspnoea, sleeplessness, 
F qiSices n of" faintness, pains in the loins. Lavements were ordered, but it was deter- 
th o} iurgT* mme d to wait till the accouchment was over before the evacuation of 
tioninpreg- the bowels should be attempted. 

After child-birth, clysters being employed, the fecal accumulation 
appeared to break up, and there was an evacuation of two or three 
pounds of hard brown fetid matter, but there remained a collection too 
large for expulsion. The patient was worn down by nausea, fever, col- 
icky and other pains, and died 21st September. 

The colon from the caecum to the rectum was found to be intensely 
inflamed. It was a foot in circumference throughout its whole length, 
was filled with gas and with 13^ pounds (French) of solid faeces (1824, 
vol. I., pp. 233, 234). 

This case was simple. Two or three doses of Brandreth's Pills would have certainly re- 
lieved, by thoroughly removing all the fecal contents of the bowels. And no danger incur- 
red at any period of gestation to either mother or child by the use of this safe but certain 
medicine. 

Epilepsy. 488. Epilepsy. — The views of Dr. Chapman coincide with those of 

The cause Dr. PrUchard, in placing the cause of apoplexy very frequently in the 

seated in the bowels. He was led to the use of purgatives by the total failure of the 

re°moved by ordinary plans of treating the disease : " it will not do, however" he says, 

purgauot. tt merely to evacuate the bowels ; cathartics must be repeated day after 

day without interruption, unless absolutely forbid by circumstances " 

(vol. IV., 1823, p. 73). 



489. The retention of biliary, urinary, intestinal and cutaneous 
from" excretions is often the remote cause of diseases of the nervous system, 



Nervous 
diseases 



retained ex- 



cretions, as well of the neuralgic as of the spasmodic and maniacal groups (New 
Series, 1852, vol. X., p. 97). 

Neuralgia 490. Whenever there exists " induced local susceptibility " morbid 
from morbid elements in the blood act most obviously in inducing neuralgia. Mala- 

matterinthe . ,. ,« / - 1 -i-i-i . 

biood, which rta m&j be present therein, yet remain latent and harmless until this 
part predis^ state occurs. So also the materies morbi of rheumatism or gout may 
Sue?' ^ocai n } r aD0U t until it is specially manifested in some locality rendered 
disease. more susceptible by predisposing causes. It may be observed that 
poisons in general have a specific elective affinity for certain portions of 
the nervous system (New Ser., 1852, vol. X. p. 103). 

aii our 491. We find that under certain circumstances a drug does good, and 

medTdnf e is we employ it when those conditions present themselves. The modus 
rie™ce. exper operandi is often totally unknown, and though it would be very satisfac- 
tory to know it, yet we can dispense with it, and from experience alone 
prescribe our remedies with very considerable success (New Ser., 1851, 
vol. VEIL, p. 204). 

Erysipelas 492. The condition of the alimentary canal should be carefully 

e r d 0m and ta pS- watched in erysipelas, for we have long suspected that it arises more 

trid/ceees. frequently from its derangement than the generality of the profession 

are aware. Excreiyientitious matter allowed to putrvfy in the fecal tube 

will not only operate as an irritant upon the whole system, but from the 

close and constant sympathy which holds between the cutaneous and 



THE DOCTRINE OF PURGATION. 



121 



mucous surfaces, may be expected to exert a deleterious influence more 
immediately upon the skin. Hence the erysipelas bilcosum and gastri- 
cum of many writers (p. 371, Ser. I., 1828, vol. IX). 



493. In the concluding stages of the putrid fe 
1 been long neglected before assistance was pr 
the most tedious and inveterate forms of the disease (ibid). 



^evers, when the bowels Putrid 
had been long neglected before assistance was procured, we have seen Sat* from* 

neglect of 
bowels. 



Boyle, James, Surg., A Treatise on Epidemic Cholera in India. Lo 



n- 



don, 1821. 



494. It sometimes happens, after patients are despaired of, they have 
a critical evacuation of viscid bile. When this circumstance takes place 
the patient invariably recovers. I have known it to occur in cases when 
the pulse had been almost imperceptible for twenty-four hours. I looked 
on the obstruction of the biliary ducts as a source of irritation to the 
nervous system generally, and the nausea and sickness of the stomach as 
an effort of nature to free herself from an unaccustomed evil. These 
views and a general want of success in practice induced me to embrace 
ideas perfectly new on the subject. Emetics and purgatives were adopted 
as the most likely means to answer the various purposes of clearing the 
stomach, removing obstructions of the biliary ducts, and exciting a new 
action in the vascular system (pp. 51-61, condens.). Many successful 
cases given. 

The very course I pursued in London in 1831, and again adopted in New York in 1849, 
1853, and 1866. 

Chapman, N"., M. D., President of Academy of Medicine in Philadel- 
phia. The Elements of Therapeutics anci Materia Medica, 2 Vols. 
Philadelphia, 1821. 



Cholera— its 
cause, and 
purgation 
its cure. 



495. Gout. — My impression, very concisely stated, is, that this dis- 
ease, if not originating m, has a most intimate connection with, certain 
state of the alimentary canal. It generally commences with those symp- 
toms which denote a depraved condition of the stomach and bowels 
(p. 190). 

496. I have now for many years habitually employed purgatives in 
the paroxysms of gout, and with unequivocal advantage. Not content 
with simply opening the bowels, I completely evacuate by active purging 
the whole alimentary canal. This being accomplished, all the distress- 
ing sensations of the stomach which I have mentioned are removed, the 
pain and inflammation of the limb gradually subside, and the paroxysm, 
thus broken, speedily passes away. To effect these purposes, however, it 
is often necessary to recur to the remedy frequently (ibid.) 

497. Palsy. — Dissatisfied with this course (the-usual routine of bleed- 
ing, blistering, and stimulating embrocations to which he formerly had 
recourse) I have for many years abandoned it, and rely now almost ex- 
clusively on evacuating the bowels by the drastic purgatives. Of the 
propriety of the change I can entertain no doubt, the success having 



Gout— its 
origin. 



Cure : by 

powerful 

purgation. 



Palsy. 
Bleeding re- 
jected. 



Purgation 
hi 'g/ili/ suc- 
cessful. 



122 THE DOCTRINE OF PURGATION. 

exceeded my most sanguine expectations. To do justice to the practice, 
it should be steadily persevered in, and aided by such remedies as the 
case may from time to time demand (p. 193). 

Llotd ? Eusebius, A., M. D., Treatise on Scrofula. London, 1821. 

Serofuia. 498. The very great influence which evacuations from the bowels 

have over the rest of the body cannot be denied by any impartial ob- 

Purgation serV er i it is therefore certain that by increasing or diminishing them we 

— its action ' „</ 7 7 o t-i* 

explained, are able to produce a decided effect on the whole, or, as 1 have proved 
before, on a particular part of the body. Thus, if there is much general 
irritation, or local irritation and inflammation, by increasing the intesti- 
nal evacuation — taking care, however, not to irritate the bowels — we 
may very much relieve both the one and the other (p. 162). 

When Brandreth's Pills are the purgative there is no danger of irritating the bowels. 

Nickoll, William, M. D., General Elements of Pathology. London, 

1822. 

unity ot ^9. We speak of the body as being composed of distinct sets of 

the human structures — the vascular, the nervous, the muscular ; or else we treat of 

y ' it after the manner of geographers, as consisting of the head, the thorax, 

Disease not tne abdomen, &c. Whichever mode we adopt, we acquire a habit of 

local but considering each portion which we enumerate as a distinct and isolated 
fact. The consequence is, that when any deviation from health occurs, 
our attention is fixed upon, the diseased condition of this particular part 
of the body, while every other portion is supposed to preserve its former 
healthy state. It is evident that each part cannot be considered as a dis- 
tinct insulated republic, but as a constituent portion of the general com- 
monwealth, whose health is dependent upon a certain condition of every 
portion of the body- (X.) 

Shaw, John, M. D., On Partial Paralysis ; a Paper read before the 
Medico- Chirurgical Society of London, in April, 1822 ; a Narra- 
tive of the Discoveries of Sir Charles Bell in the Nervous Sys- 
tem, by Alexander Shaw, Surg. London, 1839. 

Nerves, ^00. By experiments upon the portio dura he (Sir Ch. Bell) demon- 

Those with strated that it was a motor nerve exclusivelv, and had no power of be- 

ooeroothave . . ^ TT . J \ , . . r 

only one stowing sensation. When cut across, m the living animal, the motions 

those Ctl °wi\h of a certain set of muscles were immediately arrested, but the sensibility 

doubie 00 func a °f ^ ie surface supplied by the nerve remained undiminished. Upon sub- 

tion, namely mitting the fifth pair to experiment, a totally different set of phenomena 

™Znsation. presented themselves. This nerve, although it arises from the brain by 

T of 9 ner 1 ™ tw0 roots, has one of its origins nearly four times larger than the other. 

^inate* * * It was found that when those branches which proceed simply from 

from the the larger root were cut across, only one endowment — sensation — was 

/romthe destroyed; whereas upon cutting across those branches in which the 

spiU row! ar ' fibrils of the two roots were united together in the same sheath, not 

only sensation, but the power of motion, were destroyed (pp. 9, 10). An 

attempt was made to apply the new observations, in a similar manner, 



THE DOCTRINE OF PURGATION. 123 

to the pathology of the spinal marrow. Certain affections of the upper 
or lower extremities, supplied by these spinal nerves, sometimes occur, 
in which the sensation of the limb is destroyed, while the motion remains 
entire, and vice versa (p. 11). 

501. Now, as it has been established experimentally that motor T he cause of 
power belonged to the anterior roots, and sensation to the posterior, it f %S£j£ r ^ d 
was concluded that when motion, in these cases, was lost, it depended of impan-ed 
on a morbid condition of the anterior or motor column of the spinal 
marrow ; while, if sensation was lost, it depended on disease of the pos- 
terior or sensitive column (pp. 11, 12). 

These butcheries lead to little good in a practical way. 

502. I shall make a few remarks upon a question which has particu- 
larly excited the attention of physicians of all ages, since the time of p iSSoIi e of 
Galen, " Why sensation should remain entire in a limb when all volun- the above. 
tary power over the action of its muscles is lost ; or why muscular power 

should remain when feeling is gone \ " . . In answer, Galen said : that 
two sets of nerves went to every part ; one to endow the skin with sensi- 
bility, the other to give the muscles the power of voluntary action. This Galen's 
opinion was probably founded on a mere theory ; but the facts lately ° pm 
discovered, and the observations which have been noted in attending to 
the phenomena of disease, though they do not afford absolute proofs of 
Galen's supposition, still go far to establish the fact, " that every part of 
the body which is endowed with two or more powers, is provided with 
a distinct nerve for each function" (p. 13). 

503. The form of t/ie nerves, which at the same time endow the 

skin with sensibility and the muscles with the power of voluntary mo- ««Av"orig- 
tion, is such that they appear to be single cords ; but if we examine the in ^f^ 
origin of any of these nerves, we shall find that it is composed of two 
packets of fibres, which arise from distinct parts of the spinal marrow. 
These origins are soon enveloped in the same sheath, so as to appear to 
form a single nerve (p. 13). 



om 
lie 
root. 



504. It is not too much to suppose that either of these origins may 
be affected, while the other remains entire. To prove this by ocular 
demonstration will perhaps be impossible. But we have already seen treatment. 
examples of the consequences of injury to a nerve that has a single root, N f ^Ii u n 8 8 a 9 f " 
viz., the " portio dura ; " for, if we cut it, there will be only one set of proceeding 
actions paralyzed ; while by dividing a nerve which has a double origin, ™wf T 6 
viz., the fifth, we shall destroy two powers, namely, voluntary motion teri d in a the, 
and sensibility. "We know, also, that when we cut through the trunk of bowei*, ai- 
a nerve going to the hand, we destroy both sensibility and the power of c^tlpurja- 
motion. . . If the view here taken be correct, it may lead to this rule of ^thekS 
practice: If only one set of functions of a spinal nerve be deficient, we ^^i™, 
should apply our remedies to that part of the system from which the *ng the gen- 
nerve arises ; but if both functions are impaired, we must direct our era i e nt at " 
inquiries to the state of the nerve in the whole course, from its origin to 



Localaj>pli- 
cations and 



124 THE DOCTRINE OF PURGATION. 

its distribution, as the loss of power is probably owing to some affection 
of a part of the nerve after the two sets of filaments, by which it arises, 
are united together (pp. 13, 14, 15). 

— ■ It may here be observed that Mr. Shaw was a pupil of Sir 
Charles Bell's, and that his treatise was based upon the latter's 
opinion, given in a short " Essay on the Anatomy of the Brain," 
printed and distributed among his friends in 1809 or 1811. (See 
A. Shaw, p. 14.) 

Pklng, Daniel, M. D., An Exposition of the Principles of the Path- 
ology and of the Treatment of Diseases. London, 1823. 

*5f pS£ 505. In enteritis and peritonitis I have trusted more to purgatives 
n testin n a < i- a * tnan to Weeding, and I have no reason to regret this confidence. The 

purge use of purgatives, it has been objected, must increase injlammation : the 

without fear m » -f J • ,z • f j j.v ' . . • ,. J . 

of increasing effect, nowev er ; vs otherwise • and the testimony ol experience must on 
mation" fl and tliis as on other occasions, supersede all a priori reasonings. But as a 
why not. matter of reasoning, the conclusion against purgatives on this ground is 
not legitimate (p. 219). 

ortgfnaT e and 506. It does not follow, that an agent which is related with a secret- 
^fateS. 7 m g function so as to increase it, should also be so related with inflam- 
mation, which frequently suspends secretion, as to augment its intensity. 
The, danger On the contrary, in the way of reasoning, it would appear that if secre- 
^uTging tion is suspended by inflammation, that which restores secretion must 
wi cient l ef- diminish inflammation. 
ergy. Setting reasoning for the present aside, I suspect that in cases in 

which purgatives have been supposed to increase intestinal inflammation, 
it is because these means were inadequately employed (ibid.). 

Dyspepsia. 59^ Dyspepsia, whether simple or accompanied by disordered func- 
tion of the liver, chronic pains in the side, &c. When the inconvenience 
attending purgation has passed away, then an improved state of the di- 
gestive organs succeeds (pp. 307-309, condensed). 

Chorea. 508. Chorea. — In the few cases which have occurred to me of this 

Uaithy disease, some of which were severe ones, it has yielded to purgatives in 

sto pear. ap " about three weeks. The stools have commonly in about this period 

assumed a healthy appearance, and the spasmodic action of the muscles 

has quickly ceased (p. 245). 



Chronic 

rheumatism 

— cured by 



509. A gentleman had chronic rheumatism, chiefly affecting his 
knees and shoulders. He went out on a cold damp day ; in the evening 
freTpnrga- \\q had rigors ; the rheumatic pains left the extremities, and he was 
taken with something like syncope, sense of constriction at the bottom 
of the throat, of weight in the chest, with a fluttering irregular pulse of 
160 a minute. I gave him a full dose of calomel, salts, senna and jalap, 
which produced eight or ten stools in as many hours. 

The next day he was able to lie flat in his bed. The purgings were 
continued. In four days his pulse came down to 60, and in a few days 
he began to recover rapidly (p. 217). 



THE DOCTRINE OF PURGATION 125 

510. Humoral Pathology may be said to have been perfected by mcmorai 
Boerhaave (Preface, p. 1). pa W0Qy ' 

511. So unsettled is the state of pathology that those who read are Medical ig- 
skeptics in all its doctrines ; and those who do not read are left to the trance, 
guidance of a sort of intuition, which is not always productive of happy 
results, but very frequently suggests, through the course of a long life, 

only reiteration of the same error (p. 1). 

512. It appears to me, then, in the case of the " peccant humors," n ^^ nt 
that their phenomena are not produced by a mechanical agency. It is . original 
more agreeable with the results of analytical inquiry to conclude that Tie Ict?on. eir 
the animal poisons contain latent properties of a vital hind, which are 
related with those of the same hind in living bodies / that the phenomena 

of disease or death, which ensue from the operation of the animal poi- 
sons in living bodies, are according to the nature of the properties which 
are engaged in this relation (p. ii.). 

513. In my own experience it has been invariably the case, that B i Mdi ng\n- 
those who have sustained great losses of blood suffer more or less from duces deter- 
what is called determination to the head. The symptoms most common- wood. 

ly are intense pain and throbbing in the forehead or back of the head, 
with a pulse seldom under 90 (p. 23). 

514. It is common in severe and threatening forms of cerebral dis- Bleeding in 
orders, notwithstanding previous loss of blood, to resort to the lancet, and orders /aS 
to repeat copiously and frequently, if the symptoms continue. I have 
observed that this practice has generally had a fatal termination 

(p. 86).. 



515. I have been in the habit of confiding in purgatives to the almost 
total neglect of the lancet ; but these purgatives have not been of a af^el 
milk-and-water kind. I have given 6 grains of calomel, 6 grains of Fu '3''£ <s 
James' powder, followed by a 2-ounce draught of senna and salts with strongest 
half a drachm of jalap in it. If this has been rejected, it has been re- ^exhibited!' 6 
oeated in less than an hour, and repeated as often as it was rejected, until 
it has produced copious evacuations from the bowels (ibid). 



purga- 
a at ion 



516. One, and perhaps an important effect of such purgatives, is to 
make a great revulsion to the vihole intestinal canal, which is commonly ™£ 
followed by almost perfect relief to the head, and perhaps an immediate explained 
subsidence of the pulse to 100 or 110. The tendency to disorder of the 
head is afterwards easily kept within safe bounds by small repeated doses 
of purgatives (ibid). 



126 



THE DOCTRINE OF PURGATION. 



Cramptof, John, M. D., On Tinea. See Transactions of the King's 
and Queen's Colleges of Physicians in Ireland. Vol. IV, 

1824. 

Ringworm. 517. Tinea, or Ringworm. — Having exhausted my patience with 

gatio^ ur ' trials of all enumerated topical remedies, the treatment which I finally 
adopted was, first to use simple poultices, aided by a constant use of 
purgatives, and the tepid bath (p. 60). 

In scald head and ringworm the patient should use Vinegar of Bloodroot as an external 
application twice or thrice a day, and Brandreth's Pills so as to purge freely. Read directions. 

Hosack, David, M. D., Medical Essays. New York, 1824. 



Femr. 
Hosack's def- 
inition — its 
effects if pur- 
gation is neg- 
lected. 

If nature 
does not re- 
move impu- 
rities, art 
must, or 
death fol- 
lows. 



Effects of 
retained 
faeces. 



518. " Fewer is a disease of the whole system ; the absorbing, the circu- 
lating, and the excreting systems of vessels are all affected by it. . . 
Fever cannot long continue without inducing debility in the heart and 
arteries. It not only wastes the power of the solids, but by the derange- 
ment of the functions and excretions, and especially by the retention of 
those materials which should have been thrown out of the system as 
noxious, which in health are constantly ejected, the circulating fluids 
become changed and vitiated, and thereby become additional sources of 
irritation to the heart and arteries" (vol. II., p. 93). 

From this view we infer that, unless by some salutary power inhe- 
rent in the system itself, or by some means suggested by art, the greater 
irritability of the whole system be diminished, or the morbid changes 
induced in the fluids they circulate be counteracted, these causes of 
fever mutually operating upon each other must increase and fever be 
continued, until the vital principle be totally expended (pp. 93, 94). 

519. Attention should be daily given to the bowels for the purpose 
of evacuating their offensive contents, especially of the lower tract of 
the alimentary canal ; for, these malcontents being retained, not only 
in some instances become the source of irritation to the intestines them- 
selves, producing diarrhoea, but by their absorption into the mass of 
circulating fluids, which are thereby rendered still more malignant, chey 
necessarily constitute fresh sources of febrile excitement (p. 98). 



Typhus 520. I believe that the typhus fever of our country owes much of its 

Mer?ury* in- malignity to the indiscriminate use of mercury (p. 101 — Report to the 
creases its Governors of New l ork Hospital, Sept., 1819). 



malignity. 



Malignant 
pleurisy. 



Bleeding 
destroys. 
Ionics use- 
less, even in- 
jurious. 
Purgation 
saves. 



521. The prudent physician will of course carefully abstain from the 
use of blood-letting and other depleting remedies (in malignant pleu- 
risy). But he will not certainly guard against debility by the excessive 
use of hrandy and ardent spirits. So far from promoting the excre- 
tions of the system they actually restrain those very evacuations 
which it should be an object to promote, and by which alone we are 
enabled to counteract the typhoid state of the body in this or any other 
febrile disease (p. 197— Letter of Dr. Hosack's to Dr. T. E. Beck, Feb. 
3d, 1813, on the fatal epidemic prevailing at Albany). 

Brandy and all alcoholic stimulants retard the decarbonization of the bLood, because the 
oxygen of the atmosphere has greater affinity for alcohol than it has for carbonic acid 



THE DOCTEINE OF PURGATION, 



127 



522. Gout is exclusively an inflammatory disease of the whole sys- 
tem as well as of the part affected. Apoplexy, palsy, angina pectoris, 
asthma, habitual catarrh, eruptions on the shin, obstructed viscera, and 
dropsy, arise from the same habit of body and from the same causes 
— the effects of an overloaded state of the blood-vessels (pp. 234, 235). 



Good, John Mason, M. D., The Study of Medicine. 
1825. 



5 Vols. London, 



Various dis- 
eases from 
retention of 
impurities. 



523. Toothache is often produced by a remote cause, as sordes, in the 
stomach (vol. I., p. 41), or whatever tends to render the fluids acrimo- 
nious, as long use of mercury. 

Chronic rheumatism, or acrimony in the stomach, produces nervous 
toothache (ibid., p. 57). 



Toothache 
from morbid 
matter in the 
stomach ; — 
also nervous 
toothache. 



524. The grand proximate cause of cardialgia, gravel, and gout, is cardiaigia, 
debility of the stomach, whence, among other evils, a morbid secretion JJjjy** ^ 
of gastric juice. The debility is not confined to the stomach, but ex- disorder of 
tends to the intestinal canal and the other viscera. 

The debility is evident from the habitual costiveness which so pecu- costweness 
liarly characterizes this affection. The imbecility of the liver is equally J h ^ h *Jj tual 
obvious from the small quantity of bile that seems to be secreted, or its s>mp 0I 
altered and morbid hue, as evinced by the color of the faeces (ibid., p. 
159). 



525. The lungs are also in many instances apt to associate in the 
morbid action of the digestive organs, when it has become chronic, and 
to produce a peculiar variety of consumption — dyspeptic phthisis (ibid., 
p. 160). 

It must be obvious that, if the chyle which originates in the stomach 
should be conveyed to the lungs in an unhealthy condition, its peculiar 
stimulus must be changed in its mode or degree of action, and the lungs, 
in consequence, suffer (ibid., p. 163). 

The medical treatment : We must restore the debilitated organs 
to thelr proper tone (ibid., p. 164). 



The lungs 
are impli- 
cated ; bad 
blood is 
made, and 
consump- 
tion fol- 
lows. 



526. Colica — colic. — Among the chief causes, acrid, cold, or indi- 
gestible esculents, worms, calculous or other balls congested in the in- 
testines and obstructing their passage, as scybala and indurated faeces 
(ibid., p. 195). 

Cure. — Warm fomentations — clysters. Purgatives should be at- 
tempted by the mouth, though the vomiting is sometimes so incessant 
that we can get little or nothing to stay on the stomach. But the at- 
tempt must be made, and steadxly persevered in (ibid., p. 196). 

527. Constipation. — As the fasces are forced forward by the peristal- 
tic action of the intestines, it is obvious, whenever this action is weakened, 
there must necessarily be a retardation, and, consequently, an accumu- 
lation of faeces. In some instances this accumulation is prodigious. . . 

In one case which ended in death, the cause being mistaken for preg- 
nancy, the colon measured in circumference twenty inches, and on dis- 
section was found to contain three gallons of fasces (ibid., pp. 232, 233). 



Colic from 
acrid mat- 
ters. 



Persevere in 
purgatives. 



Constipa- 
tion — mor- 
bid matters 
in the intes- 
tines. 



Interesting 
case of dis- 
tended colon. 



128 



THE DOCTRINE OF PURGATION. 



variety of 528. Effects of constipation, when long continued : pains in the head, 

manifesto- nausea, febrile irritation, general uneasiness in the abdominal region, 
constipation congestion in the abdominal organs, and hence an impeded circulation 
of the blood, piles, varices of the lower limbs, colic (ibid., p. 234). 



Powerful 
purgatives. 



529. If laxatives fail, the more powerful purgatives must be had re- 
course to, till the patient can habituate himself to evacuate the bowels at 
a certain hour every day (ibid., p. 235). 



Diarrhoea 
from acrid 
ingesta ; — 
purge. 



530. Diarrhoea. — Chief causes: u acrid ingesta" and obstructed bile. 
Often antecedently to the looseness there is a sense of sickness, and per- 
haps a few slight torminal pains. But if the disorder do not prove its 
own remedy, it is easily removed by any common purgative medicine 
(ibid., p. 240> 



Astringents 531. It requires to be restrained with caution/ for a sudden cure, 
n^mf da™^* an d especially a sudden transfer to a state of costiveness, has often pro- 
duced some severe complaints, and, in one or two instances, epilepsy and 
phthisis (ibid.) 



Worms. 



Purge— 
and why. 



532. Worms. — Dr. Heberden says : " Till some more certain remedy 
shall be discovered, nothing will be more serviceable than to keep the 
bowels loose. By their irritation they augment the secretion of mucous, 
in which also they involve themselves." 

By keeping the bowels loose we prevent the accumulation of this slimy 
material in which the worm burrows, and, if we have reason to believe 
that such accumulation has taken place, the best plan is to give active 
purgatives (ibid., p. 329). 



Piles- 
physiology. 



533. Piles derive their existence perhaps in every instance from a 
turgid and varicose state of t/ie anal veins, covered with a slight thick- 
ening of the inner membrane of the rectum (ibid., p. 363). 



Retained 
faeces the /> 
cause. J( 



534. Causes: — Local irritation produced by indurated and retained 
congested state of the liver and adjoining viscera, &c. If left 
to themselves, they swell into tumors, and become so painful as to pre- 
vent walking or sitting (ibid). 



^mlnett. ^35. Jaundice is easily reproduced in those who are subject to it, 
symptoms in- by flatulence, acrimonious or indigestible food. The bowels are for the 
1C cure. e most part costive and moved with difficulty (ibid., p. 390). 



Yellow-gum 
—purge. 



536. Yellow-gum— jaundice of infants. — A dose of any active pur- 
gative will generally be sufficient to remove the obstruction (ibid., 
p. 404). 



Fever — 
1 [ippocratic 
definition. 



537. Fever. — It was the opinion of Hippocrates that fever is an 
effort of nature to expel something hurtful from the body, either ingen- 
erated or introduced from without (vol. II., p. 44). 



THE DOCTRINE OF PURGATION. 



129 



538. There is no writer of the present day, perhaps, who has carried 
this view of the subject farther, or even so far, as Professor Frank, 
who regards typhus, plague, petechias, and all pestilential fevers, and 
indeed nervous fevers of any hind, whether continued or remittent, not 
only as proceeding from specific contagions in the same manner as ex- 
anthemas, but from contagions producing a like leaven in the system, 
and matured and thrown oft' through the various outlets of the body, 
by the same process of depuration (ibid., pp. 45, 46). 

539. Typhus. — The term is derived from Hippocrates, and means to 
smoulder, or burn and smoke without vent. When a typhus has once 
arisen, the effluvium from the living body during its action is loaded 
with miasms of the same kind, completely elaborated as it passes off 
(ibid., p. 224). 

540. Dr. Hay garth and Dr. Bancroft show from numerous cases, p Xn2tent 
that the miasmatic poison of typhus, when received into the body, con- for seven 
tinues in a latent state at least for seven days from the time of exposure purgation 
to the contagion, before the fever commences. . . . remove ref the 

A peculiar state of the body gives a peculiar tendency both to gene f t i s g °eiabora e . 
rate and receive typhus, whilst some seem to be favored almost with a ted. 
natural immunity (ibid., pp. 227, 228). 



"All fevers 
are from im- 
purities from 

without 
meeting with 
impurities 
from with- 
in." 
Dr. Frank's 
opinion. 



Typhus. 
The body 
exhales 
miasms. 



541. Dysentery : — primary a disorder of the colon, so considered by 
Sydenham and Dr. Cheyne; — first gripings, then dejections, and the 
fever follows. Sydenham's chief remedy was active purgation twice 
every other day, with warm diaphoretics on the days when the aperient 
was not employed (ibid., pp. 552-556, cond.). 



Dysentery, 
from the co- 
lon ; — cure : 
active ptir- 
gation. 



542. Eruptive fevers. — Whenever any diseased action is taking place 
internally, there is a constant effort exhibited in the part, oi in the sys- 
tem generally, to lead it to the surface, where it can do but little mis- 
chief. . . It is by means of the fever that the disease works its own 
cure, for it is hereby that a general determination is made to the sur- 
face, and the morbid poison is thrown off from the system ; but the 
fever may be too violent, and from accidental causes of the wrong kind 
(vol. III.; p. 5). 

543. The grand principle in the treatment of small-pox, as of all 
the- other exanthemas, is to moderate and keep under the fever ; and how 
ever the plans that may have been most celebrated for their success 
may have varied in particular points, they have uniformly made tin's 
principle their polar star, and have consisted in different modifications 
of cold water, acid liquors, and purgative medicines — heat, cordials, and 
other stimulants having been abundantly proved to be the most effectual 
means of exasperating the disease and endangering life (ibid., p. 109). 

Dr. Mead seems to have been almost indifferent as to the kind of 
purgatives employed, and certainly gave no preference to mercurial pre- 
parations. His idea was, that all were equally beneficial that would 
tend to lower the system ; and in this manner he accounts for the mild- 
ness of the disease after any great evacuation, natural or artificial (ibid., 
p. 110). 



Eruptive fe- 
vers— a, nat- 
ural effort to 
rid the sys- 
tem of mor- 
bid matter. 
The benefit 

of putff't- 

tion pal- 
pable. 



Small-pox. 

The fever 
kept under 
by purga- 
tives. 

Strong 
evacuation 
the principle 

of euro. 

Stimulants 
increase the 

power of 



130 THE DOCTRINE OF PURGATION. 

Hypochon- 544. Hypochondria. — " The digestive organs are almost always tor- 
causes Indf- pidP Some kind of acrimony is also almost found in the stomach, and 
cate the cure, particularly that of acidity. The pain in the epigastrium may be re- 
lieved by the pressure of a belt broad enough to support the whole of 
the lower belly. Congestions in one or more of the abdominal viscera 
are a frequent result, and not unfrequently a primary cause. . . 

Hence we see why the bleeding piles are. often so serviceable as 
to have obtained the name of " medicina hypochondriacorum " (vol. 
IV., pp. 158, 159). 

Paris, J. A., M. B., Pharmacology, 6th Ed., London, 1825. 

HaBSen- ^45. Purgatives. — The extent of their importance and value were, 
dor 3 ed. however, never justly appreciated until the valuable publication of Dr. 
Hamilton on this subject. . . . His practice has clearly proved that a 
state of bowels may exist in many diseases, giving rise to a retention of 
feculent matter, which will not be obviated by the occasional adminis- 
, tration of a purgative, but which requires a continuation of the alvine 
stimulant, until the healthy action of the bowels is re-established. Since 
this view of the object has been adopted, numerous diseases have re- 
ceived alleviation from the use of purgatives that were formerly treated 
with a different class of remedies, and which were not supposed to have 
any connection with the state of alvine evacuations (p. 167, vol. IX 

Fever. 546. Thus in fever the peristaltic motion of the intestines is dimin- 

£c e m2?i3 ished, and their feculent contents are unduly retained, and, perhaps, in 
diminished. p ar t absorbed, becoming of course a source of morbid irritation. This 
fact has been long understood, and the practice of administering cathar- 
tic medicines under such circumstances has been very generally 
adopted. 

Emptying 547. But until the publication of Dr. Hamilton, physicians were 

intestines not aware of the necessity of carrying the plan to an extent beyond that 
n cie S nt ffi * of merely emptying the prima vim, and they did not continue the free 
use of these remedies through the whole progress of the disease (ibid). 

purgatives 548. Cathartics are essentially serviceable, also, in several diseases of 

^neurosis™ the class neurosis, which are generally intimately connected with a mor- 
bid condition of the alimentary passages (p. 168, ibid). 

%fteHa' ^^' Chorea and hysteria have been very successfully treated in this 

chlorosis; manner. The diseases incident to puberty in both sexes are also best re- 

("Emmena- Ueved by a course of purgative medicines, and their effects in chlorosis 

gogues.") have conferred upon many of them the specific title of Emmenagogues 

(ibid). 

aiso good as 550. But the therapeutical utility of cathartics extends beyond the 
*%3t£ffi mqpe fectdent evacuations which they may occasion. In consequence of 
the stimulating action which some of them exert upon the exhalent ves- 
sels, they abstract a considerable portion of fluid from the general current 
of the circulation, and are, on that account, beneficial as antiphlogistics 
(ibid). 

Dr. Paris is sciolistic as to the history of purgatives ; their use was better understood in 
the time of Parey (1620) than when Hamilton wrote (1794). 



THE DOCTRINE OF PURGATION. 131 

551. For the same reason they may act as powerful promoters of ab- They pro- 
sorption, for there exists an established relation between the powers of «0D? a sorp " 
exhalation and absorption, so that when the action of one is increased, 
that of the other is augmented. Certain purgatives, as I have just stated, 
exert their influence upon the neighboring organs, and are calculated 
not only to remove divine sordes, but to detach and eliminate foul con- 
gestions from the biliary ducts and pores (ibid., p. 169). 

Why not say the truth, and also remove congestions and relieve pain in the most 
distant organs. 



552. There is no principle in physiology better established than that 



Chemical 
remedies in 



climates and 
seasons. 



which considers vitality as a power engaged in a continual conflict with conflict with 
the physical, chemical and mechanical laws to which every species of 
inanimate matter is invariably subject (ibid., p. 209). 

— And yet chemical remedies are constantly prescribed by 
the " SCIENTIFIC " physician! 

Alxsle, Whltelaw, M. D., Materia Indica. London, 1826. 

553. Hepatitis. — A viscid and badly prepared bile, producing ob- ti In ^ a y m t %' 
struction and irritation, is the most immediate source of evil, and so nvl>\ from 
constantly does neglected constipation precede an attack of hepatitis, and Stl & at hot 
that we cannot for a moment deny but that it must powerfully contri- 
bute towards hurrying on the organic derangement by binding up what 
should daily be carried off (p. 549). 

Monat and Henderson, Surgs., Narrative of the March of the 13lh 
Regiment of Foot, from JVuddeah to Berhampoor, in 1826. See 
Madras Journal, vol. II 

554. Two individuals who were largely bled became convulsed and Bloodletting 
died, and after death it was found that, though the heart was empty, the SSiu^Su 
vessels of the head were loaded with blood. It was thus clearly indicated 

that, whatever it was that excited the hearts inordinate action, blood- 
letting vioidd not subdue it / for, as long as a drop of blood remained, it 
was sent to the head (Journ., p. 327). 

Andral, Jr., Gk, M. D., Clinique Medicate. Paris, 1827. 

555. In indigestion (embarras gastrique), consisting of loss of appe- ^digestion. 
tite, bad taste in the mouth, loaded tongue, irregularity of the bowels, 
sensation of constriction or weight at the epigastrium, and occasional wcnes do 
nausea. This train of symptoms we have often seen to resist the appli- ^Sn^ 6 
cation of leeches to the epigastrium, low diet, diluents, etc., and rapidly pwgatiak 
give VKiy to the exhibition of a brisk purgative. Do purgatives, by ex- 
citing the stomach and bowels together with the auxiliary neighboring 
organs, re-establish the power of digestion f Do these remedies change, 

in some unknown way, the mode of secretion in the liver and pancreas ? 

We know not. But this we know, that the treatment above mentioned 

is very efficacious, and that the antiphlogistic treatment is useless, if not twf^mi. 

injurious (chap. IY. f)- 0U8> . 



132 



THE DOCTRINE OF PURGATION. 



Illustrative, 
case. 



Nature 

shows the 

way to cure. 



556. Andral, in illustration, gives many cases ; "No. YI. is se- 
lected. A young man entered the hospital with high fever, violent 
pulsating pain in the head, obstinate costiveness, and other symptoms. 
Leeches, the pendiluvium, lavements, and tisans were employed to no 
purpose. On the tenth day the patient was seized with spontaneous 
vomiting of a large quantity of green bile, which was followed by a 
smart purging of yellow liquid matter. Next day every symptom of 
his malady was gone. The patient was discharged, " cured by Dame 
Nature." — Andral asks, " Would not a brisk purgative or two in the 
beginning have cured the disorder ? " 

"Why of course they would. Six Brandreth's Pills given on the first or second day 
would have done it. 



^SoSSmu ^^' P ur 9 a ti ves -> by revulsion, diminish the activity with which the 

the current fluids tend to the part originally irritated and congested. . . But another 
moMfy *S« influence which has been less noticed, is that which they may have upon 
ITxSiooS the composition of the blood, which they must modify by means of the 
materials which they extract from it. It may be asked, what is the 
nature of their influence upon the blood, according to whether they 
chiefly excite the flow of perspiration, of mucous, or of bile, and what 
changes of composition they may occasion in the blood ? This is un- 
doubtedly an interesting subject for investigation (Quoted in Copland's 
Diet., p. 250, vol. I, Art. Blood, § 160). 

Chambers, William, M. D., Physician to St. George's Hospital. On 
Continued Fever. See Beit, and For. Med. Eev., 1827, Vol. VI 

Fever. 558. Continued Fever. — Those who have been in the habit of treat- 

Ea $teady d m g ^ s di sea se must have observed that in most instances, when pur- 
purgation. gatives have been early and steadily administered, all the symptoms 
have in a short time yielded to them (Eev., p. 161). 

Scudamore, Charles, M. D. A Treatise on ilie Nature and Cure of 
Rheumatism. London, 1827. See British and For. Med. Eev. 
1839, Vol. VII. 

559. In no way is a degeneracy into chronic symptoms so certainly 
introduced as by that injudicious employment of general bleeding which 
changes enfeebles the constitution and still leaves the rheumatic disposition in 
chrontcrheu- great force (p. 70 — Brit, and For. Med. Eev., p. 343). 

matism. 

Purgatives 

replace 

bleeding. 



Rlieuma- 
tism. 



we 



Continue 
purgation 
until evacu- 
ations are 
healthy. 
Examine 
stools and 
urine. 



560. In proportion as we employ purgatives with judgment, so do 
diminish the necessity of using the lancet (ibid). 

561. In regard to the freedom and continuance of this treatment, 
we shall inform ourselves in great measure by the nature of the excre- 
tions, alvine and urinary ; for, while the faces are unnaturally dark, and 
the urme is dense, of a deep color, &c, it is incumbent upon us to make 
daily employment of purgative medicines (p. 96 — Eev., p. 344). 

Also continue purgation with Brandreth's Pills while severe pain continues, even if the 
stools are healthy. 

562. A course of sarsaparilla often proves useful in that kind of 
chronic rheumatism which is accompanied by general derangement of 
the constitution without the particular affection of any internal organ. 



THE DOCTRINE OF PURGATION. 



133 



We see that, as the health of the system improves, morbid irritability 
lessens, the flesh of the patient increases, his looks and strength improve, 
and the rheumatic pains pass away (p. 370 — Rev. 353). 



Abercrombie, John, M. D., Pathological and Practical Researches on 

Diseases of the Stomach, <&c. Edinburgh, 1828. 

563. It has become a kind of fashion to refer symptoms to morbid 
conditions of the liver, without any good ground for considering them as 
being really connected with that organ. But as a practical man, anxious 
to be guided by observation alone, there are three classes of facts whicli 
have appeared to me worthy of much attention in reference to this sub- 
ject, namely : 

1. That I have frequently seen such complaints get well under very 
mild treatment, as regulation of the bowels, and a little attention to diet ; 

2. That I have seen such patients put through long and ruinous 
courses of mercury without any benefit, and afterwards found the com- 
plaint removed by a course of mild laxatives ; and 

3. That I have known patients die of other diseases while these 
alleged affections of the liver were going on, without being able to dis- 
cover in the liver, upon dissection, the smallest deviation from healthy 
structure (p. 320). 

564. In chronic inflammation of the liver free and continued purging 
is expressly recommended (p. 361). 

Aitoesly, James, M. D., Researches into the Causes, Nature, and 
Treatment of Prevalent Diseases in India. Edinburgh, 1828. See 
Med. Chtr. Rev., 1828, Vol. VIIL, Ser. I. 

565. Thus, in recruits and other strangers to the climate, on their 
arrival in India, when the biliary secretion is much increased, the tem- 
porary obstruction produced by exposure, wet, &c, often occasion the 
most formidable symptoms of disease, and when the obstruction is over- 
come, an immense quantity of vitiated bile is passed. It is reasonable 
to suppose, if the gall-bladder and ducts be over-distended with their 
contents, then vital contractility may be weakened, and thus the evil 
will be increased, until some internal or external cause supervenes, which 
shall enable the organ to throw off the load which oppresses it, and dis- 
charge its morbid secretion (Rev., p. 419). 

if- 

566. The accumulation of mucous on the internal surfaces of the 
duodenum may also obstruct the mouth of the common duct, and pre- 
vent the flow of bile into the alimentary canal, until the obstruction be 
overcome or removed (p. 307). 



Dyspepsia 
and'sopposED 
chronic in- 
flammation 
of the liver 

cured by 

PURGATION. 



Mercury 

useless. 



Real chron- 
ic inflam- 
mation of 
the Iver — 

PURGE FREE- 
LY AND CON- 
TINUALLY. 



Fevers in 
the East Li- 
dies. . 

Natural or 

artificial 

purgation 

alone can 



Mucous ob- 
struction a 
cause of fe- 
ver ; remove 
it by purga- 
tion. 



Bayle, M., M. D., On the Influence of Gastric Affections in the Produc- 
tion of Mental Maladies. See Revue Medicale. Paris, 1828. 

567. Mr. Bayle proves by numerous cases that chronic inflammation insanity 

of tfte mucous membrane of the stomach and bowels produced various d«S5£isto£- 

forms of insanity, and that the form of the mental hallucination was ach - 
often determined by the physical malady in the stomach. . 



134 



THE DOCTRINE OF PURGATION. 



Malaria 
produces 
many dis- 
eases, ac- 
cording to 
dilation. 



Brown, John, M. D., Medical Essays on Fever, dec. London, 1828. 

568. Malaria produces intermittent and remittent fevers, cholera, dys- 
pepsia, bilious diarrhoea, liver disease, jaundice ; and Dr. McOulloch 
adds, rheumatism and neuralgia (p. 46). 



Cooke, William, Surg., A Practical and Pathological Inquiry into the 
Sources and Effects of Derangement of the Digestive Organs. Lon- 
don, 1828. 

Fatal accu- _. • 1 "/• ■» 7 •>/» 

mutations— 569. In disease there will sometimes be /a^ accumulation of ja&ces 
upon reports in the intestines, when both the patient and attendants report that the 
tfon, buTSt °owels are freely relieved (p. 129). 



Constipa- 
tion. 

Loose stools 
not sufficient 
— examina- 
tion re- 
quired; — NO 
"half meas- 
ures. " 



Case. 



Fever. 



570. Various diseases arising from constipation cured by full purga- 
tion. 

In cases of constipation we must be careful that the discharge of 
loose motion does not deceive us, for this may happen without the bowels 
being sufficiently acted upon. We ought never to be satisfied, in any 
serious case, without careful examination with the hand ; for it will fre- 
quently happen, even after fluid dejections, that a large accumulation of 
faeces shall exist. 

On the 12th of December, 1818, I was consulted respecting a little 
boy four years of age, who for several days had been unwell. I pre- 
scribed a dose of calomel, which, in the course of the day, affected his 
bowels three times, the motions being loose and yellow. His diet con- 
sisted chiefly of fluid aliment, and of this he took but little. On the 
morning of the 13th he had considerable/^r remaining. A powerful 
purgation (calomel and jalap) was given. Early next morning he voided 
an excessive quantity of formed and hardened faces, some parts of 
which were of a black color. After this evacuation the febrile symp- 
toms speedily subsided (p. 129). 



Impaired 
digestion 
cured by 

FULL PUR- 
GATION. 



571. I was consulted by an elderly gentleman who had been suffer- 
ing under chronic and protracted derangement of the digestive organs, 
and who believed that he had kept his bowels freely open by ordinary 
domestic aperients. A more efficient purgative was, however, prescribed, 
and to his surprise and comfort he voided as much solid excrement of a 
brown color as would more than half fill a large pot-de-chambre (p. 130). 



Active pur- 
gation — its 
usefulness. 



572. Active purgatives are not only merely required in cases of accu- 
mulated faeces, but are sometimes useful by instituting morbid action, 
by setting up a temporary disease through the alimentary canal. 
Something may be attributed to the increased secretion, but the main- 
tenance of morbid action has sometimes considerable influence in con- 
trolling functional affections which did not originate from gastric dis- 
ease (pp. 131, 132). 



palpitation 573. In evidence of this view is given a case of palpitation of the 
oftnebeart. fa ar f CU red by purgation (p. 132). 



THE DOCTRINE OF PURGATION. 



135 



574* A case is given of peritoneal inflammation cured by full purga- Peritoneal 



tion, when " both the practitioner and the nurse informed me that the 
bowels were quite open " (p. 130). 



inflamma- 
tion. 



575. In the summer of 1824, 1 was called upon by a maiden lady 
ao-ed 34. She informed me that for some months she had been in such 
a"state of distress, from mental depression, that life had become com- 
pletely burdensome. She had neither inclination for food nor exercise. 
She slept but little and passed restless nights. I prescribed laxatives 
and sea air for a few weeks. She grew worse. On her return to the 
city, powerful purgatives were employed three times a day, and in a 
week she felt quite a different creature (pp. 192, 193). 



Mental 

depression 

cured by 

powerful 

picrgation. 



576. In 1816, I attended a lady who had "not been well " for two 
years, during which period she had been under the care of a respectable 
medical gentleman without deriving advantage. She was also subject 
to pains in her right side, appetite impaired, countenance yellow, rest 
disturbed. Employed active purgation (calomel and jalap). The first 
day she had twelve dejections, the others six or seven each. The pain 
soon ceased, appetite was good, countenance cheerful, and she was again 
feeling comfortable. 

She was now desired to take half the former dose of opening medi- 
cine every third night. 

In this case the constipation had existed so long that it seemed pru- 
dent to act freely on the bowels at first, and gradually lessen the strength 
of the purgative (pp. 232, 233). 



Amenor- 
rhea cured 
by full pur- 
gation. 



Continua- 
tion of the 
purgative 
treatment. 



577. A lady in the seventh month of pregnancy had been affected 
for some time with what was considered a quotidian ague. Every day, 
at nearly the same time, she was attacked with rigor and violent shiver- 
ings which continued for half or three-quarters of an hour, and was 
succeeded by hot and sweating stages. On being consulted I deemed it 
expedient to administer some opening medicine before other steps were 
taken. The bowels being freely acted upon in the course of the next 
twenty-four hours, the fever did not return (pp. 285, 286). 



Quotidian 

ague 

during 

pregnancy 

cured by 
purgation. 



Case. 



578. A gentleman informed me that he was recently consulted re- 
specting a family with ague. Bark had been frequently given without 
success. Finding that their bowels were much disordered he prescribed 
some opening remedies, intending to give quinine afterwards, but the 
ague had ceased (p. 286). 



Another case 

of ague. 
Bark useless. 



Monro, Alexander, M. D., Morbid Anatomy of the Brain. London, 
1828. See Med. Chir. Rev., Ser. 7, Vol. VIII, 1828. 



579. Hydrocephalus. — Brisk cathartics are to be administered regu- W/iroceph- 

larly, especially at the outset and during the first period of the disease ; by retained 

for the quantity of feculent matter contained within the intestines in w«ylpJ'J« 

many cases is really surprising. One instance now occurs to us. The ^ ull i / 
patient was a young lady who, after an attack of fever, during whiV 



freely. 



136 



THE DOCTRINE OF PURGATION. 



Case. 



fetid stools. 



head symptoms predominated, and had not been opportunely nor suffi- 
ciently overcome, was seized with all the signs of water in the head ; 
and as her bowels had been rather disposed to astringency throughout 
the fever, they became exceedingly torpid, indeed almost unmanage- 
able, on the establishment of hydrocephalus. 

Five or six common doses of drastic purgatives were required before 
the bowels would answer, said fetid and bulky stools were daily passed 
for three weeks under this stimulation , without any solid food having 
been taken during that time (p. 38 — Rev. p. 385). 



580. And instituting a new and healthy action in the secretory appa- 
ratus by a degree of warmth and local remedies adapted to the sensibility 
of the part affected (ibid). 



McKenzie, William, M. D., A Sketch of the Natural Cure of Dis- 
eases ; in Glasgow Medical Journal, February, 1829. See Beit. 
& For. Med. Key., 1847, Vol. XXIII. 



The Mood, 
ever chang- 
ing and ever 
new, and 
disease. 



581. The body is almost altogether fluid ; nine-tenths of it are so, 
and only one-tenth solid. The fluid pnrts are in a perpetual state of 
change, being decomposed by one set of functions and recomposed by 
another. . . . Our fluids, by means of digestion, absorption, circula- 
tion, respiration, and secretion, are in a constant revolution. By these 
processes there is effected an uninterrupted decay and restoration of the 
body ; and one can not doubt that the natural cure of diseases depends 
very much on the existence and on the perfection of this revolution. 
N"ay, it is extremely probable, that one of the principal intentions served 
in this mode of carrying on life is the prevention and removal of dis- 
ease (Rev. p. 587). 



By purgation with Brandreth's Pills we can change the entire body in from a third to 
half the time it is changed in the ordinary course of nature, and with entire safety. Case 
of 



Stephens, Henry, Surg. Treatise on Inflamed and Obstructed Hernia, 
london, 1829. See Med. Cher. Eev. Ser. I, 1829, Vol. XI. 

strangu- 582. Mr. Lawrence has, under the head of " slow strangulation," 

lat irim } vf a ' described a state of obstructed hernia from fecal accumulation, and 
tamed faeces, without doubt such a state often exists (p. 62 — Rev. p. 112). 

Brandreth's Pills to this poor patient would have been the complete doctor, producing 
certain relief, and, in all probability, would have cured the rupture. 



Stoker, William, M. D. 

1829. 



Treatise on Continued Fevers, dec. Dublin, 



Typhus 
fever. 



583. Typhus fever is connected with morbid changes that previously 
take place in the fluids, and produce morbid actions, and sometimes 
permanent change of structure in the solid parts. These changes are 



THE DOCTRINE OF PURGATION. 



137 



distinguishable from those which occur in inflammation, and the morbid Dr. stoker's 
action excited relatively by these changes in the blood are also distinct. 
In inflammatory fever, increased action ; in typhus fever, debility is 
almost the immediate consequence (p. 74). 

The remedies employed by me in mixed and typhoid fevers, and 
arranged according to their relative importance, are : 

Mixed fevers — cleanliness, ventilation, cool regimen, plentiful dil- 
uents, and purgatives. 

Typhoid fevers — yeast, wine, and aperients (p. 113). 



and modus 
procedendi, 



with 

pur gat ire 
medicines. 



584. In both ague and intermittent neuralgia, I believe the disor- 
dered function of digestion, and the consequent morbid condition of the 
chyle and of the other contents of the stomach, whether ultimately 
absorbed or carried into the sanguiferous system, or carried downward by 
theprinm vice, become in their transit a chief cause of all the succeed,- 
ing symptoms (p. 357). 



Ague and 
neuralgia 
from re- 
tained im- 
purities. 



5 S 5. When these periodic diseases become, however, 



more 



estab- 



These impu- 



Ushed, it is probable that not only the fluids are further affected, but ca u? e eS of h ^r- 
that consequent changes are excited, and hence the morbid condition of aanic dis - 
the fluids may be the primary source of organic disease (ibid). 



The following quotations establish the absolute necessity of having by us a purgative to 
which we may always apply with safety for relief; and we have it in Brandreth's Pills. 

Copland, James, M. D. Dictionary of Practical Medicine. London, 
1830. New York Ed. by Dr. Ch. A. Lee, 1846-1852. 



586. A belief is too generally entertained that fecal matters and 
sordes will not accumulate in the colon unless the patient has been con- 
stipated. But they may collect in its cells, the more central part of the 
canal allowing daily evacuation / and they may even remain there for 
a considerable period, producing much irritation, and even a relaxed 
state of the bowels, thereby misleading the judgment of the prac- 
titioner as to the pathological state constituting the disorder. ... In 
many cases, when the morbid collections have become acrimonious, an 
irritative diarrhoea continues for some time, or recurs at intervals, before 
the morbid matters are fully thrown off, owing to spasmodic constric- 
tions of parts of the bowels. . . On these occasions the evacuation is 
often preceded bv gripes, tenesmus, or a scalding sensation in the anus 
(vol. I., p. 450, Art. Colon, § 6). 



Fecal matter 

may 
accumulate 
where there 
is no con- 
stipation — 
watch and 
purge. 



Effects. 



587. Purgations are used in order to occasion a local determination of 
blood, and thus derive it from the seat of disease, to evacuate the vis- — BSE ac- 
cera, increase the discharge from the mucous surface, 
secretions in adjoining organs (ibid., p. 218). 



and augment the 



tion 
aims. 



and 



588. The fetor, &c, of the breath, and of the perspiration, &c, con- InUr ru P ted 



secretion — 



sequent upon interruption of the abdominal secretions, indicate that im 

purities have accumtdated in the circulation, and that they are being action of the 

eliminated by the lungs and the shin. So long as the vital energy is 



secretory or- 
gans. 



138 



THE DOCTRINE OF PURGATION. 



Causes of 
disease. 



sufficient for the due performance and harmony of the functions, inju- 
rious matters are seldom allowed to accumulate in the blood to the ex- 
tent of vitiating its constitution, without being discharged from it by 
means of one or more organs. But as soon as this energy languishes, or 
is depressed by external influences and agents, and the blood is thereby 
either imperfectly formed or insufficiently animalized and depurated, 
some one of its ultimate elements or proximate constituents become ex- 
cessive, and the chief cause of disorder, which terminates either in the 
removal of the morbid accumulation, or in a train of morbid actions and 
lesions (vol. L, p. 23 8, Art. Blood, § 116). 



Defective 
secretion 
causes ab- 
sorption of 
morbid mat- 
ter vitiating 

the blood 
and produc- 
ing disease. 



589. Thus it will appear that changes in' the secretions and in the 
blood itself are most influential in the production, perpetuation, and 
aggravation of disease. . . Thus, also, it will appear not only that hurt- 
ful matters carried into the circulation, and ultimate elements or proxi- 
mate constituents allowed to accumulate in it, owing to the imperfect 
performance of some alimentary function, will be removed from it when 
the vital influence is sufficient for the task, but that both kinds of inju- 
rious agents will, according to their nature, become productive of a viti- 
ated state of the blood, of the secretions formed from it, and even of the 
various tissues themselves, when the state of vital manifestation is insuffi- 
cient to remove them from the frame (ibid., p. 239, § 117, ibid.) 



Defective se- 
cretion, if not 
counteracted 
by vicarious 
action, pro- 
duces vitia- 
ted blood. 



590. I consider the grand pathological inference to be fully estab- 
lished : that the interruption or obstruction of any important secreting or 
eliminating function, if not compensated by the increased or modified 
action of some other organs, vitiates the blood more or less ; and if such 
vitiation be not soon removed, by the restoration of the function prima- 
rily affected, or by the increased exercise of an analogous function, that 
still more important changes are produced in the blood, and ultimately 
in the soft solids, if the energies of life are insufficient to expel the cause 
of disturbance, to oppose the progress of change, and to excite actions 
of salutary tendency (ibid., p. 240, § 124, ibid.) 



Miasma — 
action on 
organic life, 

impairing 
the matura- 
tion of the 

blood. 
Reaction if 
there is suffi- 
cient energy 
— course of 
disease, if 
not. 



591. Miasmata produce a morbid impression on the nerves of organic 
life, followed by depression of the vital influence; the functions of diges- 
tion and secretion languish, and, owing to the imperfect performance of 
secretion and assimilation, the necessary changes are not fully effected 
in the blood, and thus the irritating and otherwise injurious matters ac- 
cumulate in it. . . The vascular system becomes excited by the quantity 
and quality of its contents ; and when the vital energies are not too far 
depressed for its production, the excitement becomes general. The ac- 
celerated circulation has the effect of exciting the organic functions, of 
restoring the secretions which were impeded or interrupted, and thereby 
of removing the morbid state of the circulating fluid, after which the 
return of health is rapid. Wlien, however, salutary reaction is not 
brought about, owing to the morbid depression of the vital energies and 
to changes which had taken place in the blood, the vitiation of the blood 
proceeds ; the secretions are also vitiated, the solids affected, one or 
more vital organs suffer in an especial manner, the energies of life are 
exhausted, and various organic lesions are induced, having reference to 



THE DOCTRINE OF PURGATION. 139 

the previous state of the system, the kind of changes produced in the 
blood, and the agencies in operation during the progress of the disease 
(ibid., p. 240, § 125, ibid.) 

592. M. Andral states that " he has often found in the blood-vessels Morw/or- 
a curdy, friable matter, of a dirty-gray color, and resembling either the XebSdJhS 
semi-concrete pus of chronic abscesses, or the sanies of malignant ulcers, SterT b to 
or cephaloid matter, broken down and mixed with blood." And similar the Mood. 
instances are recorded by Bichat, Beclard, and Veljpeau. In all these 

cases, abscesses, tubercles, or other morbid formations, also existed in 
some part of the body (ibid., p. 246, § 144, ibid.) 

593. Morbid secretions should he frequently evacuated, in order that Evacuate 
vital power may not be further reduced by their morbid impression on ™L\o Se p T rt 
the nerves and mucous digestive smface, and that the possibility of the Jon'o? imp£ 
absorption of any part of them into the circulation may be thereby 
avoided (ibid, p. 249, § 158, ibid.) 



rities. 



morbid mat- 
ters. 



594. In all the alterations of the blood resulting from the introduc- Bloodletting 
tion or absorption of morbid matters from parts previously diseased, sorption A of 
whatever tends to lower nervous and vital power, or to promote absorption 
— more particularly blood-letting, which operates in both these ways — 
ought to be guarded against, and a diametrically opposite plan of cure 
adopted, not neglecting the promotion of the depurative and excreting 
functions (ibid., § 159, ibid.) 



Fecal mat- 
ter in the 



595. Fecal matters collected in the ccecum often induce inflammation, 
or the paroxysms of pain are very acute, sometimes attended by vomit- ca&cmn 
ing and all the symptoms of the most severe colic, or even those of ileus various and 
(§ 10). The symptomatic disorders, when the viscus is much distended sequ^nce^of 
either by fecal or by other matters, or by flatus, are numbness of the ^J^^g 0110 
right thigh, oedema of the right foot and ankle, sometimes retraction of 
the testicle, or frequent calls to empty the bladder, and sometimes 
hemorrhoides, uneasiness and pain in the right iliac region, often extend- 
ing to the bypochondrium, various dyspeptic symptoms, costive or irregu- 
lar state of the bowels, occasionally diarrhoea, with scanty, offensive, and 
mucous stools (§ 11). The efforts made to evacuate the bowels are often 
attended by severe tormina and even retching. I have seen several 
cases of varicose veins of the leg, or indolent ulcers, and a case of disease 
of the bones of the foot, the occurrence of which was evidently connected 
with great disturbance and accumulations in the ccecum. . . The com- 
plexkm is deficient in clearness, and with the surface often covered with 
an oily or dirty moisture ; the perspiration becomes fetid and the breath 
offensive ; the soft solids lose their elasticity, and are slightly emaciated ; 
. . . and at an advanced stage the symptoms more clearly manifest that 
the blood is imperfectly depurated, or that it is affected by the absorp- 
tion of a portion of the excrementitious matter retained in the caecum. 
In addition to these symptoms, general debility and disinclination to any 
physical or mental exertion are often complained of (§§ 10, 11, 12; Art. 
Colon, p. 330, ibid.) 



from 

secretions ; — 
remove these 
by purga- 
tion. 



move 
cause 



140 THE DOCTRINE OF PURGATION. 

cholera,- 596. Even in cholera, in which the eruption of an increased quantity 
of morbid secretions into the duodenum occasions copious discharges 
from the stomach and bowels, with cramps, &c, we are not justified in 
concluding that any organic change is present beyond simple irritation 
of a temporary kind, excited in the villous surface by the acrid state of 
the secretions passing along it (ibid., p. 624; Art. Digestive Canal, 
§ IT, B). 

ohorm-its 597. Among the chief predisposing causes of chorea is a neglected 
state of the bowels, leading to accumulations of deranged secretions in 
the primae vise, torpid functions of the liver, and other secreting and as- 
similating organs. The most exciting causes are the irritations of worms, 
of morbid matters accumulated in the bowels (Stoll, Baldinger, and 

Wendt), and fright, improper employment of lead, mercury, &c. (Be 
Haen), suppressed eruptions and discharges (Thilenius, Darwin, and 

Wendt.) (Ibid., p. 389 ; Art. Chorea, § 12, III. 13 B.) 

cure:-re- 598. Purgatives have been recommended in chorea by Sydenham, 
mse by Whylt, Hamilton, Cheyne, and others (ibid., p. 392, § 23, VL, ibid.) 
purgatives. ^he fl rst indication is to remove morbid secretions said fecal accumu- 
lations, the usual cause of the irritation of the organic nerves (ibid. p. 
394, § 29, B, ibid.) 

Diarrhea. 599. Idiopathic diarr/iwa, when recent, requires demulcents or dilu- 

morbid a mat d - eTi ^ merely, in order to facilitate the discharge of acrid or accumulated 

ter ur S ld he matt er. This having been accomplished, disorder soon ceases. But the 

away, irritating substances may be partly retained and keep up a prolonged or 

remittent state of the disease, with griping pains and scanty stools, which 

may be partly feculent, mucous, or serous — the latter predominating, 

when the irritation is considerable. In this case much discrimination is 

requisite in selecting the aperient which is obviously required ; for, if it 

be insufficient, the disorder will be prolonged (ibid., p. 609 ; Art. 

Diarrhoea, § 25, VII.) 

Brandretu's Pills are all that is needed, and discrimination is not required. 

crisis— nius- 600. Illustration of Crises. — A person exposed to the causes of 

autumnal fever of a bilious and remittent form, experiences during the 

earlier stages the usual symptoms of impeded or interrupted secretion, 

and general vascular excitement. In consequence of interrupted action 

bid of the emunctories the blood contains an increasing proportion of effete 

the^tem. * materials, particularly of the elements out of which bile is formed. 
These for a while increase and modify the vascular excitement, or, when 
excessive in quantity, or especially noxious in quality, even tend to ex- 
haust or depress it. But they at the same time being appropriate 
stimuli to the biliary and depuratory viscera, serve to restore their 
impeded functions, to turn the balance of excitement in favor of them, 
thereby to reduce the morbid vascular action, to cleanse the circulating 
fluid from its impurities, and to change in other respects its condition, 
and thus * the disease terminates with an apparent collapse, followed by 
a copious discharge from the bowels, consisting of morbid bile and of 
the excretions from the intestinal mucous surface — the products of the 
noxious matters which had accumulated in the blood, but which is now 



tration o;. 



The removal 
of mor 
matter out of 



ease quietly 
follows. 



THE DOCTRINE OF PURGATION. 141 

being eliminated from it, by a renovated as well as an increased secret- 
ing and excreting function. Now, this procession of morbid phenom- 
ena shows, that the ancients were not so far wrong as many of the 
moderns suppose, when they believed that critical evacuations were bene- 
ficial, chiefly because they conveyed a morbid matter out of the system 
(ibid., p. 516, Art, Crises, § 15). 

601. As the office of the excreting organs is to expel those elements , in disease 
which ai % e effete, and would be injurious to the frame if retained in the Swirl 
blood, it nmst necessarily follow, that any. interruption to their function ^proper 
must be highly injurious. The dropsical effusions in various cavities emnmctoHes 
following interruption to the action of the kidneys, folly illustrate this, ly ; if not 
As a large quantity of ingested matters is carried into the blood, either uwev, SS* 
directly from the stomach or along with the chyle, and discharged from 
it by the emunctories, it is evident not only that the kind of ingesta will 
aifect very remarkably the properties of the excretions, but that obstruc- 
tion or interruption of any one of them will be followed by serious effects, 

unless some other organ perform an additional office vicarious of that 
which is suppressed, and even in this case disease will generally ulti- 
mately arise (ibid., p. 668, Art. Diseases, § 99). 

602. "WTiat are most diseases, hut either suppression or excess in the what disease 
secretions or excretions f (ibid.) 

603. Dropsy from Disease of the Kidneys. — In a very great major- ^™J^~/™ 
ity of instances, where effusion proceeds from this cause, the irritating thus fluid 
nature of the fluid poured out, superinduces inflammation of the mem- quanty^th? 
branes and cellular tissues containing it, and thereby aggravates the thTdisUs? 
disease, and accelerates a fatal issue / for if it be considered that when 

the functions of the kidneys are interrupted, excrementitious or serous 
plethora will be the result ; and that the watery parts of the blood which 
are effused from this cause must necessarily contain a considerable 
quantity of the injurious matters usually eliminated by these organs, 
the irritating quality of the accumulating fluid here contended for will 
be admitted (ibid., p. 705, Art. Dropsy on the Chest. § 52). 

604. Purgatives are very applicable in dropsies generally, on account Purgative*, 
of their deobstruent operation when uninterruptedly continued, or of moving tile 
their influence in deriving from the seat of effusion, in draining the ca S«^" 
fluid parts of the blood from that circulating in the intestinal tubes, in every fonn 
thereby lessening excrementitious or serous plethora, and favoring the the disease. 
absorption of the effused fluid. They constitute a most important part 

of the treatment of every form and state of the disease (ibid., p. 710, 
§ Cj6, ibid.). 

In hydrothorax, cathartics and purgatives, especially the hydra- 
gogues, often afford speedy relief (ibid., p. 739, § 172, ibid.). 



605. Frequentlv affection of the brain is induced by irritation of the stomach 
gastro-enteric surface. In children this is remarkably common, and 



disordc.) 
causes 



even in adults a slight degree of disorder of the stomach is often fol- SSTo?a 



lowed by headaclie, somnolency and imcapahility of mental exertion. 
The occasional dependence of epilepsy in adults, and of convidsions in 



nervotlS 
character. 



142 THE DOCTRINE OF PURGATION. 

children, upon morbid action in the digestive canal is well known. In- 
flammation of the membranes or of the substance of the brain, and acute 
hydrocephalus sometimes also supervene upon gastro-intestine irritation, 
and in the course of their development render obscure, or entirely mask, 
the previous ailment. For, as Lallemand has remarked, as soon as the 
cerebral affection even partially obscures sensibility the existence of dis- 
order in the digestive canal is ascertained with great difficulty. In my 
opinion, the majority of cases denominated "spinal irritation" are 
caused by gastro-enteric disorder (vol. II., p. 30, Art. (lastro-enteric 
Disease, § 3). 

—\ tS a ?udi* ^06. A judicious exhibition of purgatives will frequently remove 
cious use re- irritation of the digestive canal, especially if it be caused by unwhole- 
Stuseofdis- some ingesta or morbid secretions, or fecal accumulations; and even 
ea how. nd when it cannot be referred to either of these, but rather to the state of 
vascular action in the digestive surface, the augmented secretion pro- 
cured by refrigerent or mild purgatives may promote its resolution or 
diminish its intensity (ibid., § 4. ibid.). 

S^dT°at a s ^7. ^ ven tne occurrence of pneumonia may be favored by disorder 

of the sun of the digestive canal (ibid., p. 31, § 7, ibid.). 

samTsoSce. Its connection with diseases of the shin, is much more general than 

practitioners suppose. It is chiefly owing to the irritation of the diges- 

Arsenicm- tive mucous surface, that the cutaneous affections resist so long the treat- 

tane°ous m dis- ment prescribed for their removal. I have repeatedly seen arsenical 

ease - .and other irritating medicines exhibited in no small quantities ; and 

although they were evidently exasperating both the internal and external 

affections they were continued with a perfect belief in their applicability 

(ibid., p. 33, § 15, IY., ibid.). 

impure, 608. When the disorder of the gastro-intestinal surface is attended 

diseases of with a crowing or morbidly excited appetite, food is taken in larger quan- 
kWneys^and tity than it can be digested, and much imperfectly formed chyle is 
sMn. carried into the blood where it excites diswder of the liver, of the kid- 
neys, and often of the shin, in the course of the excretion of the unas- 
similated matters by these organs (ibid., p. 34, § 16, ibid.). 

Manydis- 609. The suppression of the excreting functions of the shin may be 
one^cause- followed — especially if the kidneys do not perform a vicariously increased 
oPtulwL function — by catarrh, or by rheumatism, or by inflammation of the 
produced l un gs or pleura, or by diarrhoea, or by dysentery, or by enteritis, accord- 
ice^/??? ing as the predisposition of parts may determine the morbid action. 
The cause or causes, whether exposure to cold or to influences depressing 
vital power, occasion, first, interruption of the depurating functions of 
the skin, and next, more or less congestion of, or vascular determination 
to, internal viscera or parts ; and, in addition to this latter effect, and as 
a consequence of the suppression of the cutaneous function, the blood is 
loaded with these excremenlitious elements which the healthy action of 
the skin eliminates. The resulting conditions of the blood and of the 
circulation are such, in many cases, as kindle diseases, either those above 
mentioned or others of a slighter or severer nature (vol. III., p. 1137, 
Art. Therapeutics, § 44). 



function of 

THE SKIN 



THE DOCTRINE OF PURGATION. 143 

610. What has been said respecting the functions of the skin, applies The same is 
likewise to the other excreting and secreting functions. Of all excreting ^hlr ° f secr h e- 
or depurating functions, those performed by the kidneys are the most ex C i ?etor- and 
rapidly fatal when impaired (ibid., p. 1138, § 47, ibid.). 

611. Tlie cure. — It is believed by many that the regular and daily constant oi- 
evacuation of the bowels is quite sufficient * but this may not always be Evacuations 
the case, as to either the fecal discharge or the biliary secretion, or even S why 7 ' 
as to both. . . Hence the importance of observing accurately the ap- 
pearance of the intestinal excretion, both in health and in disease, and This applies 
of having recourse to such means as those appearances, the frequency brandreth's 
of the evacuation, and the associated state of the disease will suggest. PlLLS - 
The several substances employed as purgatives and cathartics should be 

suited to the peculiarities of each case, and be conjoined with others of 
the same class, or with such as may either correct or promote their ope- 
ration (ibid., § 48, ibid.). 

With Brandreth's Pills you can obtain any desired effect upon the bowels or general 
system. 

612. The promotion of the several secreting and excreting functions, changes in 
whenever they are torpid or impaired, is requisite to the prevention of from retted 
many contingent evils during states of vital depression, by whatever refuuK? 
cause produced ; but it has a still more general application, for, in all f * om a f e &- 
circumstances, in states of excitement and increased vascular action, as Cl s™retin g e 
well as in those of depression, these functions are very often either tor- excZmg 
pid, or impaired, or even interrupted, and require restoration ; other- /un ^ ns ' 
wise additional or more severe and dangerous changes result, and the vice versa - 
blood, loaded with excrementitious materials, occasions the most delete- 
rious effects in vital organs (ibid., p. 1137, § 42, ibid). 

613. Next to the sedative or depressing effects produced by the cwvr.-— by 
causes of disease, the impairment of depurating functions closeiy fol- lmpSfs! he 
lows, the latter being very frequently the cause of the former. These 
functions are often restored by the same means as are employed to remove 

the primary morbid impression (ibid., § 43, ibid). 

614. In chronic, malignant, and structural maladies, the constitu- Chronicdis- 
tional or vital power is impaired, and the blood is altered more or less tmpoveriT- 
as these maladies advance, especially cancer, tubercle, rickets, &c, the e The cure b 
alteration of the blood becomes more or less evident, this fluid being promotion <£ 
thinner, poorer, or deficient in red globules. Hence the necessity of sup- tfonSSro- 
porting the powers of life by means which will neither excite nor irri- * r r ^ \iSng 
tate them, and of preserving the healthy state of the blood by conjoin- Brandreth's 
ing with those means such as will correct or prevent alterations of this 

fluid, and will, at the same time, promote the conversion of the color- 
less or chyle globules of the blood into red globules — will promote the 
processes of sanguification and nutrition (ibid., p. 1142, § 63, ibid). 

615. A person is exposed to causes, as infections, which depress or- Effects of 
ganic nervous energy, and thereby impair or suppress the more import- inttiemok 
ant depurating and secreting functions. The consequences as respects 

the blood are obvious. This fluid soon abounds in effete and injurious 
elements, increasing both the amount of the vascular contents, and 



144 THE DOCTRINE OF PURGATION. 

Brandreth's oppressing and irritating the whole vascular system, although certain 

?me S atth wm organs may manifest these effects in a more prominent manner than 

the ely S ystim others, until a salutary crisis is observed, and the morbid state of the 

into a blood is removed, or until the soft solids are changed, their vital cohesion 

di«on. y con * is loosened, and disorganization ensues (ibid., p. 1046, Art. Sympathy, 

The mutual 616. There is very intimate connection existing between the state of 

excrTting or- the blood and the depurating offices of the mucous surface of the intes- 

taSSexSe- tines, especially of the large intestines. This surface, and more partic- 

tions pro- ularlv the follicular glands, mav he considered as eliminating: from the 

duce, among - •' o ' V i i i -i -i i i -i/v 

other effects, blood redundant or decomposed blood globules, and much enete mate- 
°case—L d e?~ rials, and as thereby contributing, with the other emunctories, to the 
Change? P ur ity an d healthy condition of this fluid. The connection subsisting 
between the functions of excreting viscera, not only as altering the con- 
dition of the blood, but also as affecting each other individually • the 
influence which the state of one depurating function exerts upon the 
others through the medium of the blood, as well as through that of the 
organic nervous system, and the mutual and conjoint operation of all 
these functions, not merely in changing the physical appearance and 
constitution of the blood and the states of vital influence, but also in 
occasioning structural alterations, are among the most important topics 
comprised by a rational system of pathology (ibid., p. 1045, § 96, ibid). 



mucous 
pituitoua 



^enTcious 111 ®^- Predisposing causes of worms should, as much as possible, be 
and removed or counteracted. In furtherance of this indication, the diet and 
sordes! 3 the treatment should be adopted that are most efficacious in promoting 
the organic nervous force and the tone of the digestive organs, and in 
removing tenacious mucous and pituitous sordes, which often adhere to 
the digestive mucous surface, and which often forms the nidus in winch 
the ova of parasites are lodged and hatched. It will generally be no- 
ticed that the secretions anol excretions which in all persons form the 
principal part of the fecal discharge are seldom thrown off from the se- 
creting surfaces so quickly and entirely in the delicate and debilitated as 
in the robust and healthy, but remain or are retained in the former class 
of subjects, and become the soil in which these animals are reared (ibid., 
p. 1547, Art. Worms, § 158, B). 

Spasms. g-^g Spasms of the voluntary or involuntary muscles. — Purgatives 

Cure m pwr " are g enera Uy beneficial, more especially when the liver or brain is con- 
gested, and when the spasm is connected with acidity and flatulence of 
the digestive canal, or with accumulation of morbid secretions, excre- 
tions and fecal matters, as when spasms occur in colic, or in the course 
of gout, rheumatism, hysteria, hypochondria, &c. In these, as well as 
in some cases of other diseases, not only are morbid excretions thus 
liable to accumulate, but the Mood becomes more or less contaminated by 
effete materials, which the impaired functions of the emunctories fail of 
removing. 

JOmy&L* 619. In these circumstances purgatives should be selected with this 

the bowels view, not merely ot evacuating the contents oi the bowels, but also of 

^oimi promoting the functions of the excretory organs. When cerebral con- 



THE DOCTRINE OF PURGATION. 



145 



gestion is connected with the spasms, then active derivative purgatives 
ought to be exhibited by the mouth and in enema (ibid., p. 931, Art. 
Spasms, § 31, C). 



620. But the most remarkable cause of the slow progress of the ther- SSSS^S! 
apeutical science is to be found in the highest and most legitimate ranks of theknowi- 
of the medical profession — in the physicians themselves (§ 9) ; in wrong dies, and of 
estimates of the efficacy of particular medicines and agents (§ 7, D) ; in t£ere£ behef 
erroneous, limited, or one-sided views of the causes, seats, nature and 
procession of diseases ; of medical doctrine (§ 4, 1.) ; medical jealousies and 
contentions; opposing systems ; plans on means of cure; jarring views 
as to the efficacy or operation of certain medicines ; opposite opinions 
in courts of justice, or otherwise appearing in public ; the publicity 
given to medical discussions have an unfavorable influence on the pub- 
lic, and prevent many from trusting to medical treatment (ibid., pp. 
1130, 1131, Art. Therapeutics, § 12, 1). 



621. The blood is found altered in disease : 

1. By a change in the proportion of its constituent elements ; 

2. By the addition of foreign matters (+) (cf. G. Harvey). 



How the 
blood be- 
comes im- 
pure. 



AN HONEST PEOFESSOK. 



Marx, K. Z., M. D. Professor in the University of Gcettingen. 
eral Pathology. Gcettingen, 1833. 



Gen- 



622. The conscientious practitioner can resort but to few remedies ; 
for whenever the choice lies between what is harmless and what " heroic," 
he must unconditionally employ the former (Preface). 



Mciteria 
medica. 



Chomel, M.,M. D., Clinical Lectures on Typhoid Fever. Paris, 1834. 
See Brit, and For. Med. Rev., 1836, Vol. II. 

623. In the stools of patients, at the commencement of recovery from Typhoid 

typhoid fever, there are always scybalce; on which stools 'o7con- 

Dr. John Conolly observes : If medicine had produced the same a i V wiy S 3 ce con- 

effect earlier, wliich nature did eventually, the symptoms would have taineeyoaia. 
been milder, although the course of the disease would not have been cut 
short (Rev., p. 40). 

" The course of the disease •would not have been cut short" may admit of a " perhaps." 



Laexnkc, R. T. EL, M. D., A Treatise on Disease of the Chest. Trans- 
lated by John Forbes, M. D. London, 1834. 

624. I would therefore lay it down as a valuable practical rule in 
chronic affections of the heart, that previously to having recourse to any 
remedies intended to act directly on it, we ought to be assured that the 



digestive organs arc in a healthy state, that their mucous surfaces 



Chronic 

ht>,art-diH- 

easa. 

The first step 

(,<i i/-: taken 



are purgation. 



10 



146 



THE DOCTRINE OF PURGATION. 



free from irritation, their vascular system not morbidly distended, and 
that the liver is performing its secreting function freely and regularly 
(p. 687). 

Let Brandreth's Pilla be used in accordance with the printed directions, and there will 
be no medicines required to " act directly on the heart" The mucous coats will be freed from 
all irritating Bubstances, when the liver and the heart will, as a rule, perform their functions 
freely and regularly. 



Clark, James, M. D., A Treatise on Pulmonary Consumption, and In- 
quiry into Causes, Nature, Prevention, and Treatment of Tuber- 
culous aud Scrofulous Diseases in General. London, 1835. See 
Brit, and For. Med. Rev., 1835. 

cachexia- 625. Dyspepsia is the most fertile source of cachexia in every form ; 

sia m and Sp de- ^ a * so g enerates in derangement of the various secretory and excretory 

ranged secre- functions, particularly that condition of them in which the effete mat- 

cretion d ex " ter is imperfectly carried off (p. 223). 



626. So long as thfi constitution remains unimpaired, the ordinary 

Kee^the'sys- exciting causes (catarrhs, inflammations) may come into active play 

S f «wST a g a ^ n an0 - a gai n ) during a whole lifetime, without producing consump- 

and you keep tion ; but the moment the tone of the system is seriously lowered by 

°o{ th thi a S. s sedentary habits, insufficiency of food, impaired digestion, depression of 

ease. rnmd, excessive study, vitiated atmosphere, a very slight external cause 

will then suffice to induce the deposit of tuberculous matter (Rev., pp. 

71, 72, vol. II.) 



Conollt, John, M. D., Editor of the British and Foreign Medical 
Review, On Clark's Treatise on Consumption. 1835, Vol. XXL 

Conwnvp- ^27. Consumption is invariably the consequence of a pre-existing un- 
tgm always healthy state of the constitution, without which the accidental causes 
ties 11 ta p tL" which call it into being would have been entirely incapable of producing 
it (Rev. p. 71). 



CURE OF CONSUMPTION AND DYSPEPSIA. 

*■ Hammonton, N. J., May 7, 1866. 
"Dr. Brandreth— Z^ar Sir: I have long wanted to write to you and express my grati- 
tude for the beneficial effects that have been experienced in my own family, and in hun- 
dreds, aye, thousands of others, by the use of Brandreth's Pills. The first year my lamented 
friend Brockway sold your pills in Boston (1838) I called at his office. I was then in a de- 
clining state of health, and my friends, as well as myself, supposed my earthly voyage would 
60on terminate. Mr. Brockway urged me to take the Brandreth Pills, but having used so 
much medicine, with no good effect, I was more inclined to let nature take its course, and 
calmly submit to my fate. Mr. B. offered to give me one dozen boxes if I would try them 
as prescribed. By this I saw he had great faith in them, and I finally consented to take 
them, but not as a gift. I went home and went at it, almost hopelessly. After taking one 
box I began to feel better. Well, sir, when I had used up my twelve boxes, I was apparently 
a well, healthy man, my weight having gone from 131 pounds up to 152 pounds. I then 
ordered a supply, and between that time and the present I have retailed three thousand dol- 
lars worth of these invaluable pills, and am quite sure that I have thereby been instrumental 
in saving, not hundreds, but thousands of lives. I have given them to my oxen, horses, 
pigs, fowls, cats, dogs, and always with the desired effect. I have a wife and nine children, 
most of them born since I have used the pills. A more healthy family cannot be found 



THE DOCTRINE OF PURGATION. 



147 



"We are frequently asked how it is our children look so healthy. My wife replies that ' We 
raise them on Brandreth's Pills.' Now, my children overload their stomachs, get cold and 
out of order, like others, but they have been taught the remedy, and go and take the pills 
of their own accord. This I consider an important branch of their education, and feel as- 
sured, as they .shore off upon the voyage of life, that they know how to take care of them- 
selves. I was in trade at my last residence, North Lincoln, Me., for 29 years. I have been 
here about seven years ; I am, therefore, well known, and my statements can be verified by 
hundreds. "Yours, 

"C. J. FAY." 



CONTAGION EVEN HARMLESS TO THOSE WHO USE BRANDRETH'S PILLS. 

Each one of us, even the most diseased, has within him a germ or root of that original 
pure blood of our common mother Eve. 

This germ of pure blood supports his life, and constantly struggles to throw out from 
the circulation corrupt humors into the bowels. Brandreth's Pills assist this regenerating 
process. 

By their powerful aid we constantly make blood of a better quality, until the whole is 
renewed and purified. 

Those who desire to pass untouched by contagious maladies, who wish for soundness of 
body and mind, or to have healthful children, should use Brandreth's Pills, which cleanse the 
bowels and the blood of all unhealthy accumulations. 



Combe, Andrew, M. D. Principles of Physiology applied to Preserv- 
ation of Health, <&c. Edinburgh, 1835. Letter on the Observation 
of Nature in the Treatment of Disease. See Beit. & For. Med. 
Kev., 1855, Vol. XXL 

628. Experience shows that the physician and the remedy are useful 
only when they act in accordance with the laws of the constitution and 
the intentions of nature. . . If this be done systematically, every 
effort of nature will be towards the restoration of health ; and all that 
sHe demands from us in addition, is to remove impediments and facili- 
tate her acts (Eev. p. 509, sq.) 



Assist nature 

to remove 
impediments 



629. Instead, therefore, of medicine being superseded, as many sup- Medicine 
pose, by taking nature for our guide, it will, on the contrary, only begin « v ^ m edf C a- 
to take just rank as a science when our allegiance to nature shall become trix natur£B ■" 
practical, enlightened, and complete. . . ifature is truly the agent in 
the cure of disease $ and as she acts in accordance with^a?^ and invari- 
able laws, the aim of the physician ought always to be to facilitate her 
efforts, by acting in harmony with, and not in opposition to, those laws 
(ibid.). 

Dr. Combe in 1840 was in New Haven, Conn. We had a conversation with him on the 
great importance of purgation as a universal remedy. But the doctor could not understand 
how purgation could be useful after the bowels were emptied of their contents. How long 
a principle is uncomprehended ! and yet this great man might have lived thirty years 
longer, had he but have only investigated this one of purgation, and been governed by the 
lights of experience which he would have found to flow from it. 

Forbes, John, M. D., Editor of the British and Foreign Medical 
Review, commencing 1835. 



630. Purgation appears to be banished (in continental treatment of 
fevers ), fr<;m a fear that it may increase the irritation of the follicles of 



Fever. 



148 



THE DOCTRINE OE PURGATION. 



Purgation 
doex not in- 
crease intes- 
tinal inflam- 
mation. 

Practice 



the intestines — a fear which has sprang from too excessive devotion to 
morbid anatomy. That active purgatives, particularly in the early 
stages of fever, will increase the follicular irritation, is a completely theo- 
retical objection. The reasoning on which it is founded will not bear 
examination, and our experience in this country experimentally contra- 
dicts it (Rev. 1836, Yol. III., p. 63). 



The Doctor is a friend of Brandreth's Pills. 



Leeches, 631. In the treatment o£ fevers we have witnessed more misery and 

anTcostwe- waste of life from leeches, gum water, and costive bowels than from any 
degree of purgation (Eev. 1836, Yol. IY., p. 167). 



Poisons 
destroy the 
nervous fac- 
ulty through 
injury done 
to the blood. 



632. Physiological researches during the last thirty years have satis> 
factorily proved that most if not all of the agents which exert such 
destructive energy on the nervous system (as poisons) do it through the 
medium of the circulation, as shown by the experiments of Christison 
and Ooindet, of Brodie, Viborg, and others. And we are much mis- 
taken if future researches do not prove this equally of what we term 
the true puerperal fever. . . The entire absence of coagulum, the per- 
fect fluidity of the blood, apparently both in color and consistence to 
thin watery claret, tends to confirm these views (Rev. 1836, Yol. II., p. 
484). 



633. How many medicinal agents have been indebted for their rep- 
^meMca- a utation to fortuitous circumstances. It would be easy to show from the 
Ind S fui\ ar o C f f° rmer history of diseases that the medicine employed in the treatment 
useless drugs had no influence whatever in effecting the cure, but that the result was 
dangerous entirely owing to the efforts of nature. A physician, for example, em- 
ploys a certain medicine in a few cases and finds his patients recover ; 
hence he concludes that the treatment and the cure stand to one another 
in the relation of cause and effect. Misapprehensions of this sort pro- 
duce a very false and injurious impression upon the minds of students, 
leading them in their future practice to bleeding, blistering, and treating 
" heroically " all affections that appear to be violent and intractable 
(Eev. 1842, Yol. XIIL, p. 55). 



results in 
practice. 



In tumors, &c, Bkaotxreth's Pills affect firstly and chiefly the 

MORBID GROWTH. 



Tumors. 
Another rea- 
son why 
Brandketh\s 
Pills remove 
only impu- 
rities. 



634. " Nature gives up in the first instance that which is extraneous 
and parasitical, in preference to what is normal both in structure and in 
degree of development i. w This is an important law, observable in a 
thousand cases, without the auspicious operation of which indeed one- 
half of our labors would be in vain (ibid., pp. 330, 331). 



Acute <rheu- 635. These recommendations (continued purging in acute rheuma- 
tism) are in the highest degree important for the speedy removal of the 
disease, whether mild or severe ; and the custom of some practitioners 



THE DOCTRINE OF PURGATION. 



149 



who avoid purging from, rear of giving occasion to injurious exposure The only 
of the person, cannot be too strongly reprobated (ibid., p. 450). ™£tioZ pur ' 



636. It is evident then : 

1. That in a large proportion of the cases treated by allopathic phy- 
sicians, the disease is cured by nature and not by them. 

2. That in a lesser, but still not a small portion, the disease is cured 
by nature, in spite of them ; in other words, their interference opposing 
instead of assisting the cure. 

3. That consequently, in a considerable proportion of diseases, it 
would fare as well or better with patients, in the actual condition of the 
medical art, as more generally practised, if all remedies, at least all 
active remedies, especially drugs, were abandoned (p. 257, vol. XXI., 
1846). 

637. This lamentable condition of medicine, regarded as a practical 
art, is in truth a fact of such magnitude — one so palpably evident — that 
it was impossible for any careful reader of the history of medicine, or 
any long observer of the process of disease, not to be aware of it. What 
indeed is the history of medicine but a history of perpetual changes 
in the opinions and practice of its professors, respecting the very same 
subjects — the nature and treatment of diseases ? And amid all these 
changes, often extreme and directly opposed to one another, do we not 
find these very diseases, the subject of them, remaining, with some ex- 
ceptions, still the same in their progress and general event ? (pp. 257, 
258.) 



The resum6 
on medical 
art, nature, 

etc. 



These re- 
marks apply 
to the "reg- 
ular prac- 
tice'''' of the 
' ' healing 
art" 



History of 
medicine — 
and what it 
teaches. 



638. To be satisfied on this point we need only refer to the history Bleeding, 
of any one or two of our principal diseases or principal remedies, as mereZVy— 
fever, pneumonia, syphilis — antimony, blood-letting, mercury. Each of tb d ubtfuf cy 



these remedies has been, at different times, regarded as almost specific ^the/? 6 ^! 
in the cure of the first two diseases, while at other times they have been rious. 
rejected as useless or injurious. What seemed once so unquestionably, 
so demonstrably true, as that venesection was indispensable for the cure 
of pneumonia % And what is the conclusion now deduced from the 
clinical researches of Louis and others ? Is it not that patients recover 
as well, or nearly as well, without it ? The experiments prove, far better 
without it (pp. 258, 259). 



639. If the medical god Mercury has lost the domain of syphilis, he Mercury— 
has gained that of inflammation • and many of our best practitioners Jjj» e rei| f° tl ^J 
might possibly be startled and shocked at the supposition that their sue- questionable 
cessors should renounce allegiance to him in the latter domain, as they 
themselves had done in the former. And yet such a result is more than 
probable, seeing that there exists not a shadow of more positive proof, 

much, of the efficiency of the medicine in the latter than in the 
former case (p. 259). 

640. Truth is good. If the art of medicine, as we profess and Truth above 
practice it, cannot bear investigation, and shrinks before the light of a11 - 
truth, from whatsoever quarter it may come, it is high time that it 



150 



THE DOCTRINE OF PURGATION. 



should cease to be sanctioned and upheld by philosophers and honest 
men (ibid). 



Dr. Forbes deserves well of all mankind. 



Louis, Ch. A., M. D., Physician to the Hopital de la Pitie. Eecherches 
SWT les effets de la saignee dans quelques maladies inflammatoires, 
dee. On the Effects of Bleeding in Inflammatory Diseases, Paris^ 

641. 



A volume consisting of numerous cases to test the efficacy of 
proveTto be blood-letting in pneumony at the Hospital de la Pitie, in Paris. Some 
uSSsiS patients were bled on the first, some on the second, some on the third day 
fi S m £° n °^ ^ e attack, and so on ; some seldom, others repeatedly, with the periods 
08 ' from attack to convalescence duly noted. And from these cases he 
comes to <the inevitable conclusion that bleeding is a noxious, not a bene- 
ficial agent, in the disease — that it does not remove pain, and if it at 
all modifies it, in twenty-four hours it is generally as severe as ever / that 
bleeding seems to produce an effect only when used at a period suffi- 
ciently remote from the origin of the malady to be perhaps coincident 
with improvement. 



Blisters 
equally use 



642. Mr. Louis applied to the effects of blisters the same experimen- 
tal analysis, and came to the conclusion that in pneumonia they are 
also devoid of utility. 

Brandreth's Pills are of absolutely certain benefit in every case of pleurisy ; and in all 
inflammations whatsoever they should be used at once. Then they have never been known 
to fail. 



Louis, E. H., M. D., Pathological Researches in Phthisin. London, 
1835. 

onfytruee 1 ^ ^43. The numerical methodic, in fact, the only method in our power 

$rt!£ °of the *° P ursue > ft ™ the only control we can possess over assertion, the only 

medicine. test for opinion. Its application to a sufficient number of facts, must 

inevitably give us the most exact and best possible knowledge of those 

facts, and we would ask the individual who believes that science is 

founded on facts, what more he would require ? (p. 28.) 

By the numerical method we would be judged. Let this method be applied to effects 
Brandreth's Pills produce upon disease; and what an amount of suffering and sorrow would 
soon terminate ! No inflammation, no cholera, no fever, no pleurisy, no rheumatism, or any 
pain would cause alarm, because it would be known that a few Brandreth's Pills would soon 
restore any and every organ to health. 



Moore, G-., Surg., An Inquiry into the Pathology, Causes and Treat- 
ment of Puerperal Fever; which obtained the Fothergdilian Gold 
Medal, March, 1835. London, 1836. 

Puerperal 644. Puerperal Fever. — That early purgation is indeed an essential 
■£u*rgluon riy auxiliary in the treatment, is amply testified by those who have been 
most successful (p. 223). 



THE DOCTRINE OF PURGATION, 



151 



In every case of puerperal fever I have seen, where purgation was used at once when 
the violent pain in the womb admonished that inflammation had commenced, was cured. 
The purgative was Brandreth's Pills. Every other case where other remedies than purga- 
tive were applied was lost. In fact, forty years ago it was generally understood that puer- 
peral fever meant — death. In 1840 a friend of mine, a physician, lost seventeen cases of 
this fever one after another. I recommended purgation, i. e. Brandreth's Pills. He followed 
my plan and gave the pills, and never after lost a case. 

Paeise, M. R., M. D. Pathology of Rheumatism. See Bulletin 
General de Theeapeuttque, July, 1835, and Brit, and For. Med. 
Eev., 1836, Vol. I. 

645. Rheumatism. — Its change of situation does not change its na-. 
ture, although it goes by different names. Thus it is the same disease 
which in the head is called gravedo, in the neck torticollis {wry-neck), in 
the side pleurodynia, in the loins lumbago, and along the sciatic nerve 
sciatica (Kev., p. 255). 

CURE OF INFLAMMATORY RHEUMATISM. 

De. Brandreth : Sing Sing, Jan. 25, 1867. 

For some years I have been subject to attacks of inflammatory rheumatism, which usually 
come on every three or four months. My physicians were of the highest reputation. By 
their advice I took colchicum, citric acid, and other celebrated remedies, but none relieved 
me or shortened the attacks, which lasted for weeks at a time. In my last attack 1 con- 
cluded to try your famous pills. I was lying upon my bed at the time, suffering the severest 
pains in my feet and ankles, which no pen can describe. 

The first dose of six pills was so effective that in a few hours the pain and swelling sen- 
sibly abated, and in forty -eight hours were all gone, and I was cured and have had no 
return. 

I send you this testimonial for the benefit of others who, suffering in a similar manner, 
may know how they can find certain relief. 

I am respectfully yours, J, D. DUDLEY. 



Rheuma- 
tism,. 
The same dis- 
ease under 
various 
names 
according to 
location. 



FURTHER PROOF. 
To Dr. Brandreth: Brooklyn, Oct. 5, 1866. 

It gives me pleasure to state the good I have experienced from your pills. Since I com- 
menced their use I have felt in all respects like a new man, and the rheumatism I took them 
to relieve has entirely disappeared. At first I was prejudiced against them, because their 
operation was attended with severe griping; but on a further experience I am convinced 
such pains were only caused by the medicine struggling with and removing certain obstruc- 
tions in the bowels. I commenced with taking five pills every night on going to bed, and 
by an increase of one pill every evening ran the quantity up to twelve pills, which number 
I continued to take for ten days, aud then gradually reduced to five pills at a dose. With 
the exception of the first three doses I have experienced no pain or griping, but the opera- 
tion was both easy and pleasant. I took the pills for twenty-four days, and noticed that I 
passed a great quantity of black, bilious-looking, offensive matter, which I am glad to have 
got clear of. The Brandreth Pills take right hold of all that is deleterious in the bowels ; 
and, as I said before, I now feel like a new man, and deem it my duty to express ray grati- 
tude to you. Sincerely your friend, 

FRANKLIN L. HAWLEY, 238 Classon Avenue. 

McIlwain, Geoege, Surg., Remarks on the Unity of the Body, dec. 
Zvndon, 1836. See Beit, and Foe. Med. Kev., 1836, Vol. II. 



180). 



64:6. The whole of the body sympathizes with all its parts (Kev., p. 



Axiom. 



152 THE DOCTRINE OF PURGATION. 

"Williams, Robert, M. D., Physicicm to St. Thomas Hospital. Elements 
of Medicine. London, 1836. 

rit y the so m the 647. Certain diseases — as typhus, scarlatina, varioli, erysipelas, &c, 
disease, are produced by morbid poisons. These have definite specific actions — 
oftheniS^ latent periodicity — the phenomena varying according to the dose and 
upo/tKS predisposition of the individual. Generally these poisons act with an 
a uru f ofme i^ensity proportioned to the feebleness of the patient (Preface). 

blood. 

Bleeding 648. Bleeding. — From a careful comparison of such evidence as 

d ™«™°«,I e " exists, Dr. Williams concludes, that since the evidence against bleeding 

move the ? .,,'..,, . ° n P 

cause of dis- m lever so greatly outweighs that m its tavor, it seems demonstrated, 
"scarlet- ' and by the most practical experience as yet before the public on any 

fever, etc. ji S p 0se( j medical question, that bleeding in the cure of fewer is the ex- 
ception, not the rule / . . that the cause of the disease being a poison, it 
is necessary to remove the poison from the body in order to stop the dis- 
ease (p. 171). 

The benefit 649. The most effective treatment was found to be as follows : 

lnd. ax( Lje 6 c- Ten grains of rhubarb, or a scruple, at whatever stage the patient 

uom. was a d m itted, and barley-water enemas, night and morning, with half 

an ounce of syrup of poppies added. Success is the only criterion in 

medicine, and certainly this practice has effected the cure of a much 

larger proportion of cases than any other mode I have witnessed (p. 93). 

How infinitely superior Brandreth's Pills are to this treatment, as all who know them 
will admit. 

fcartef/evw ^50. The results obtained by the practice of bleeding in scarlet fever, 
proved to be as well as by abstracting from it, are given in the following table : 
by fl 43c cases. Of 121 per sons, treated in the Foundling Hospital, in 1786, by bleed- 
ing, 19 died, being about one in six. 

Of 60 persons, treated at the London Fever Hospital in 1829, by 
bleeding, 10 died, being the same average ; whilst 

Of 125 persons, treated by purgatives and emetics, only 10 died. 

And if Brandreth's Pills had been the purgative, not five out of a hundred would have 
died. 



Lawrence, William, Surg., Treatise on Hernia. London, 1838. 

stwmguia- 651. Strangulated Hernia. — The notions that purgatives are capable 
e pwrgaZ'es of exciting the mucous membrane of the alimentary passages, and thus 
:ica Ter producing an aggravating inflammation of the stomach and bowels, is 
groundless ; and the practical precepts founded on this theoretical and 
imaginary foundation, have always appeared to me a signal triumph of 
doctrine over the most unequivocal results of experience and the plain- 
est dictates of common sense (p. 323). 

If the bowels should not be relieved three or four hours after the 
operation, a pill of calomel, or of calomel and extract of colocynth, may 



THE DOCTRINE OF PURGATION. 



153 



be given, followed by a drachm or two of sulphate of magnesia in mint 
or plain water, and this repeated every three or four hours until the 
towels are freely relieved. If this do not succeed, a large common 
injection, with four or six ounces of infusion of senna, or an ounce of 
castor-oil 5 should be administered (ibid.) 

Give six or eight Brandreth's Pills; they will certainly relieve the bowels, and if given 
early will probably save the pain and danger of the operation. 



Kennedy, Hentjy, Surg., Editor Dublin Medical Press. Sept. 23, 1840. 

652. As soon as a quantity of blood is abstracted, that moment the 
system commences to supply the deficiency. So impatient is nature at the 
loss, that if the food taken is insufficient for her purpose, she takes back 
whatever may have previously been poured out — such as serum, lymph, 
or possibly even pus. (Cases in proof are given from Drs. McDowell, 
Stoker, and by the author.) 



Nature ab- 
hors blood- 
letting; — in- 
stead of re- 
moving im- 
purities, it 

restores 
them to the 
circulation. 



Never bleed. " Thou shalt not kill." 



Morgan, G. F., M. A. First Principles of Surgery. London, 1840. 

653. The influence of the blood on the vital functions is proved by Goodbiood 
the fact that the vigor and activity of animal life depend principally on f e ' M y as - 
the condition of the circulating fluid ; and according to the qualities of covery from 
the mass, when inflammation sets in after severe injuries, are the subse- accidents - 
quent constitutional phenomena in a great measure regulated (p. 179 +). 



654. There are two principal morbid varieties of constitution in 
which local injuries produce peculiar and extraordinary effects. The 
one is that of general plethora, attributable to over-repletion of the vas- 
cular system ; the other arises from an impoverished stale of the blood, 
coupled, in the worst cases, with a disturbed condition of the nervous 
system (p. 144). 



Morbid 
state of the 
blood from 
two causes. 



055. Nothing at the commencement (of inflammation) will suffice ivflamma- 
but free and general depletion with purgatives ; and we have by these Fr'eT'and 
means known consciousness restored after an unfavorable prognosis had r/ ;S"^ 7 J e " 
been passed (p. 147). quired. 



656. If we regard the morbid alterations in the composition of the 
blood as the primary source of fevers, we can easily explain the subse- 
quent derangement in the functions of the organs, and the vitiation of 
the different secretions during their continuance. In all cases the in- 
creased discharge has the effect of relieving the congested state of the 



mucous membrane (p. 1 TlJ -f). 



Fevers 
and vitiated 

secretions 
from impure 

blood. 



The believer in the efficacy of purgatives will thank Dr. Morgan for this testimony. 



154 



THE DOCTRINE OF PURGATION. 



Canst adt, Charles, M. D., Professor in the University of Erlangen. 
Special Pathology and Therapeutics founded on Cknical Observa- 
tions. Erlangen, 1841. See Burr. & Foe. Med. Eev., 1842 
Vol. XIII. 

iodine— hs 657. The modus operandi of iodine consists in undermining the uni- 
action. versal process of nutrition (vol. I., p. 11 — Rev., p. 331). 



As the Mood, 
so the nerv- 
ous 



658. An. asthenic condition of the nervous system is an affection 
always coincident with anemia; since, on the one hand, a normal con- 
dition of that system is indispensable to a right formation of the blood, 
as on the other normal blood is essential to a healthy state of the nervous 
system (ibid., p. 33— Rev., p. 332). 



Blood and 
pus. 



659. Severe suppuration produces precisely the same effects as ex- 
cessive venesection ; while precisely the same means which improve the 
condition of the blood produce a similar effect on that of the pus (ibid., 
p. 87— Rev., p. 336). 



Inflamma- 
tion. 
Nature's at- 
tempt to cure 
— she may 
overdo it. 



660. The phenomena of inflammation are not morbid movements, 
but consist chiefly of energetic endeavors of nature to oppose or rid her- 
self of an injurious agent or influence. Death may in this way inci- 
dentally occur from salutary efforts of nature herself, as when hemor- 
rhagic apoplexy of the brain or lungs ensues from the reaction instituted 
to repel or extrude some morbific agent or influence operating on these 
organs or elsewhere (ibid., p. 96 — Rev., p. 337). 



Mercury — 
producing 
salivation — 
no medicine 
but a poison 
aggravating . 
the inflam- 
mation. 



661. Dr. Alison of Edinburgh (Library of Medicine) denies " that 
mercury administered so as to affect the gums possesses any power of 
controlling inflammation and its consequences." And on this point the 
present writer, after considerable experience, reiterates an opinion he 
formerly expressed, that he has more frequently seen inflammatory 
symptoms aggravated or transferred to other parts, on that event {saliva- 
tion) taking place, than relieved by it (ibid., p. 3 — Rev., 338). 



Grists — an- 
other view. 



662. The discharges {sweats) which occasionally signalize the crisis 
do not contain the materia peccans. The crisis itself is the recovery, the 
discharges being nothing but the effects and proof of the regeneration 
of the unhealthy functions (ibid., p. 260 — Rev., p. 342). 



Hypertro- 
phy. 



663. Hypertrophy. — Blood-letting, if practised in moderation, is apt 

to prove fruitless ; if energetically employed, it is more likely to pro- 

Bieeding in- mote anemia, dropsy, and debility than to cure hypertrophy (ibid., p. 10 



chlorosis 664. The multifarious symptoms of chlorosis do not require separate 

fromSmp^r- attention ; since, depending on a common lesion, to wit, the deficient 



THE DOCTRINE OF PURGATION. 



155 



crasts* of blood, tliey simultaneously disappear wlien that fluid is brought fectiy eiabo- 
to its normal state (ibid., p. 40 ; Kev. p. odd). 



Huenefeldt, F. L.,M. D., Chemistry and Medicine in Close Co-operation. 



Berlin. 1841. 



G65. In the cmcum there is carried on to a certain extent a repetition 
of what takes place in the stomach and small intestines. In the colon 
are found the insoluble matters of the food, the bronze coloring matter 
of the bile, mucous, fat, soluble and insoluble salts, various azotized 
matters, etc., besides fetid volatile productions (p. 110). 



Digestion 
continued in 
the ca3cum. 



These matters being retained and reabsorbed through constipation, what an amount of 
evil is produced ! Let those who are costive beware. The bowels must be evacuated once 
at least in the day, or there can be no health and no safety. 

Munnelet, Thomas, Surg. A Treatise on the Nature, Cause and Treat- 
ment of Erysipelas. London, 1811. 

C)66. It is an easy thing for the purpose of producing an immediate 
effect, or " knocking the disease on the head," as it is often termed, to 
take from a man two, three or four pounds of blood ; but should he sur- 
vive, the probability is that he will not for several years, if forever, 
be the sound man he was before the shock his system has had inflicted 
upon it by such heroic proceedings (p. 220). 

667. Purgatives, in by far the majority of cases, if properly used, Er v^ di 
completely ^obviate the necessity of venesection, especially if they have Bloodletting 
been preceded by an emetic (p. 230). 



and purga- 
tion com- 
pared. 



This is sound doctrine. 



Ceicuton, Sir Alexander, M. D., Commentaries on some Doctrines of 
a Dangerous Tendency in Medicine, and on the General Principles 
of safe Practice. London, 1812. See Brit, and For. Med. Rev., 
1813, Vol. XV. 



668. • In typhus, bleeding is useless and reprehensible. Nature's prin- 
ciple of curing this disease is the same as that by which the paroxysm 
of an intermittent is terminated ; she reduces the quantity of circulating 
fluids until she brings about an erpiilibrium between them and the en- 
feebled moving powers by excrementitious evacuations (Rev., p. 405). 

669. The Liebig theory of the action of contagious and other animal 
poisons is, that if the exciting agent be a compound body, it will repro- 
</,/,;■ itself ad infinitum, provided the compound body on which it acts 
contains elements fitted for such an end. This theory accounts for nu- 
merous cures of syphilis without mercury by Dr. Fricke in the hospital 
of Hamburg. From lorn diet and continued purgation the parts of the 



Typhus. 
Bleeding 



Nature's 
cure — 

another 
view. 



Syphilis. 
Cure without 
any mercury 
— merely by 
purgation. 

{The LieMg 
theory.) 



* Blood globules. Brandreth's Pills not only lake away impurities, but they make the 
blood richer iu Crassainentum or blood globules. 



156 THE DOCTKINE OF PURGATION. 

blood are not supplied which are susceptible of the metamorphosis. 
Thus the poison becomes starved and purged out / the same result being 
produced as is effected in fever, by the annihilation of the desire for 
food and consequent suspension of the process of chyruification (con- 
densed from pp. 210 to ult. of Crichton). 

Gully, James M., M. D., On the Simple Treatment of Diseases. Lon- 
don, 1842. 

Natures 670. The constant tendency of the diseased tody is towards cure, and 

m —in&T 6 this for the most part by the erection of certain modes of vital action in 



view. 



other parts of the frame than that which is morbid, and by the elimina- 
tion of certain matters from the emunctories. . . Thus a fever usually 
declines just as the kidneys, the lower bowels, or the skin pour out their 
respective excretions copiously (p. 32). 

These " certain matters " have been obtained from morbid parts invariably. 

Jones, Henry Beale, M. D., On Gravel, Calculus, and Gout, chiefly 
an Application of Professor Liebig's Philosophy to the Preven- 
tion and Cure of Diseases. London, 1842. 

Gout- 671. We may diminish the proportion of the gouty material in the 

cure by pur- l 00( J . 

gation. uwuu . ^ 

1. By stopping the supply — that is, by change of diet ; and 

2. By causing an increase of secretion from the liver and intestinal 
glands through the action of purgatives. 

These medicines will have the further effect of causing the secreted 
products to be discharged from the intestinal canal, instead of remaining 
to undergo partial reabsorption (pp. 70 to 74). 

Lanza, V., M. D., Professor of Physic in the University of Naples. 
Positive Nosology. Naples, 1842. See British and For. Med. 
Rev., 1846, Vol. XXLLL 

what retards 672. The chief obstacles which impede the advance of experimental 
knowiedgein medicine are the following : 
medicine. i ^q extreme variety which prevails in different countries in plans 

of cure, popular remedies, medical usages, &c, whereby all common 

grounds of comparison are wanting. 

2. The monster-abuse of polypharmacy — the injury it has caused, 
alike to humanity and to " the art," being notorious. 

3. The number of compound remedies still in vogue, a clear relic of 
barbarism, which should long ago have been banished by the profes- 
sion. 

Leaving all these behind, medicine must commence anew to determine 
the true power and value of remedies (Rev., p. 63). 

^etS^n" 673. We first find that therapeutics must be founded on experience. . . 
practice The method of treatment to be adopted in any particular case must be 



THE DOCTRINE OP PURGATION. 157 

that which has most frequently been found effectual in some previous 
and analogous case (Rev., p. 15). 

MacLeod, Radcliffe, M. D., Physician to St. George's Hospital. On 
Bheumatism in its Various Forms. London, 1842. 

671. Acute Bheumatism. — Purgatives. — This discipline ought gen- AcvurJim- 
erall y to be repeated on several successive days y indeed, throughout the mahsm - 
whole course of a case of acute rheumatism, the due evacuation of the p urqa tion 
bowels ought to be an indication never lost sight of ; and in many cases, the , onl y de - 
where the attack is comparatively mild, this is the only form of deple- quired. 
tion required (p. 31). 

Richtek, C. A. W., M. D., Contributions to Scientific Medicine. Leip- 
zig, 1S12. 

Important Article. * 

675. The Yis Medicatrix Naturae. — This power both organizes un- vis kkmca- 
organized matter, and disorganizes vitalized matters, separating vitalized TRIX ' 
matter from the system after it has fulfilled its uses in the organism, and of ™| e ^Z 
has become, if detained, a hurtful agent (sect. 1). effete matter 

the system. 

676. If the recomposing and decomposing processes are in equi- Nature's way 
libri u m, there is health; but if the effete matter be not cast off, or a removing inJ 
hurtful agent enters the system from without, the equilibrium is de- th"s^tem. m 
stroyed, and the innate vital force sets up an action to restore it — the re- 
sulting phenomena being the phenomena of disease. So that morbid 

action consists in an interruption of the renewing or reformative pro- 
cess, concurrently with alterations m the quality of the blood, and a 
reaction of the innate vital force to restore the normal state (ibid.) 

677. The hurtful agent is eliminated from the system through the Localization 
secreting and excreting organs, or not being fully eliminated, is localized {J^SJJJjjj 
in some one or more special structures, thus giving rise to various con- 
stitutional and chronic local diseases (ibid.) 



ters causes 
local dis- 



678. Fever is a healthy process. The innate vital force, feeling the F&oers— n* 
presence of a hurtfid agent in the system, attempts its removal after the 2*J' B cn»J^ 
sa/me man ner as it removes effete matter. If the hurtful agent is not elim- j£* ^ 
inated, it is localized in an organ, and the innate vital force attempts its 
'removal by colliquation of that organ, giving rise to various changes of 
si !• net ure, and to the general symptoms of local diseases. 

Heche fever is in reality a healing process, set up to expel the hurtful Hectic fever. 
power from the organ to which it has retreated y and it is injurious only 
l>ecause the hurtful power is of such a nature, or so situated, as to re- 
quire for its expulsion a greater effort than the vital machinery will bear ; 
so that the recomposing process is never re-established, and the colliqua- 
tion goes on until the dissolution of the organism, or death, takes placo 
(sect. ii). 



158 



THE DOCTRINE OF PURGATION. 



ciiEr STht ^^' Medicines only assisting the healthy action of nature in throw- 
to act. ing off the hurtful power (ibid.) 

And this is what Brandreth's Pills produce. No more: no less. 

Schultz, C. H., M. D., Professor in the University of Berlin. On the 
Renewal of Human Life, Berlin, 1842. See Beit, and For. Med. 
Key., 1845, Vol. XVI1L 



The Hood— 
its develop- 
ment. 



Chlorosis 
and 



680. It is necessary that the organic constituents ot v the blood pass 
through their embryo state, just as the embryo itself, before they can be 
perfectly developed ; and as the lymphatic glands are the gills and pla- 
centae of the system, if these perform their functions imperfectly, as in 
scrofulous constitutions, a deposit from the unripe blood takes place. 
Hence the development of chlorosis and phthisis (p. 142; Rev., p. 392). 



Elements of General Pathology. Berlin, 1844-45. 
For. Med. He v., ibid. 



See Brit, and 



arieties 
diseases. 



681. The state of the blood circulating through the secretiug organs 
varieties "of influences their diseases. (Predispositions in the glandular and secreting 
systems.) (Rev., p. 345.) 

By a stoppage of the depurative process in the liver the whole mass 
of the blood gets charged with impurities. The dead vesicles show a 
tendency even to chemical decomposition, as in stinking secretions, nau- 
seous cutaneous affections, &c. . . The blood acts injuriously on the 
nervous and muscular system ; it is deficient in the stimulating property 
of healthy blood. Thus the brain, nerves of the senses, and muscles, 
are imperfectly acted on, are weakened, and at last paralyzed. Apoplexy, 
intermittent fever, spectral illusions, and even paralysis of the senses, 
are the result of this state. (Predispositions of the blood.) (Rev., p. 
343.)' 



Defective 
excretion;— 

a fruitful 
source of dis- 



Morbid mat- 
ters, etc., re- 
tained. 



Williams, Charles J. B., M. D., Principles of Medicine. London, 
1843. See Brit. and. For. Med. Rev., 1844, Vol. XVII. 

682. The excretions are defective in many idiopathic and symptom- 
a,tic fevers, and there can be little doubt that many of the constitutional 
effects of these fevers are, in a great measure, due to this important ele- 
ment. The positively noxious properties which excrementitious matters 
retained in the blood are Jcnown to possess, mast be taken into- account, 
when we attempt to explain the state of constitutional irritation and de- 
pression, with perversion of functions, which fevers so generally present. 
The changes in the blood may also be in part referred to defective elimi- 
nation of effete matter y and it is when the secreting organs recover their 
power, and a diarrhoea occurs, or a copious discharge of highly-colored 
urine, that these appearances cease (p. 81 ; Rev., p. 479). 



Disease from ^83. ^ ne causes °f disease are changes in the due proportions of the 
changeinthe blood, and otherwise, by respiration, secretion, nutrition, and by foreign 
matters (ibid.) 



THE DOCTRINE OF PURGATION. 



159 



6S4. In the treatment of this element of disease— -foreign morbid matters 
in the blood — the two indications which present themselves arc, first, to 
counteract the injurious operation of these matters / and second, to expel 
them from the system. We do not possess chemical antidotes which 

CAN ACT ON THE FOREIGN MATTER IN THE BLOOD WITHOUT INJURING THE 

blood itself. The other indication is more generally pursued, although 
little recognized by practitioners, to expel tlie offending matter from the 
system. The excretory organs, especially the hidneys and the alimentary 
canal, are the natural emunctories through which foreign and offending 
matters are expelled from the blood. Let ns bear in mind how often 
fevers and other serious ailments seem to be carried off by spontaneous 
diarrhoea, diuresis, or perspiration (ibid., p. 122; Eev., p. 485). 



All chemical 
antidotes 

INJURE THE 
BLOOD, 

although they 
may expel 

morbid mat- 
ters from it. 

Expel these 

as nature 

does. 



Cozzi, L., Professor of Chymistry. Analysis of the Blood in a Case of 
Lead Colic, in Journal de Pharmacie. Paris, February, 1844. 
See Edinburgh Medical and Surgical Journal, 1844, Vol. LXII 



685. Professor Cozzi, in analyzing the blood of a person severely Painters' 
affected with lead colic, discovered that the lead existed in the state of a Poison"' of 
salt, or of an oxyde of the metal, in the albumen of the blood (Ed. l 
Journ., p. 553). 



blood. 



Houston, John, M. D., Introductory Lecture in Surgery. Dublin, 
1844. 



686. The great mind of John Hunter saw and believed that the 
blood possessed in itself an independent life even while circulating 
loosely in the blood-vessels, but he knew not the nature and the seat of 
that vitality. The discovery was reserved for the physiologists of our 
days. There are particles, called globules, floating in this liquid, about 
the 3000th part of an inch in diameter, or so small that myriads of them 
are contained in a single drop. It has been ascertained respecting these 
globules that they are, each and all, endowed with a definite and uni- 
form shape, and with a development, in virtue of which they pass by 
successive transitions from a condition of origin to one of final evolu- 
tion — a veritable organization, in other words — properties which give 
them a claim to the title life, as much as those which justify the appli- 
cation of that term to the ovum, from which proud man himself dates 
his being. The atomic particles of which the blood is composed being 
thus individually alive, collectively they form a mass of which it may 
literally, as well as allegorically be said : " For it is the life of all flesh ; 
the Hood of it is for the life thereof ; for the life of the flesh is in the 
blood" 

The globules are themselves, each and all, possessed of an independ- 
ent life. I have repeatedly watched them, and have shown them to 
others, when burst from their cell-membrane, performing sundry inde- 
pendent and apparently voluntary evolutions in the field of the micro- 
scope, until to the eve the whole looked like a moving mass of creeping 
things. In this view, then, the blood is doubly alive as exhibited — first 
in its forming and taking part in the repairs of the animal machine, and 



The Hood. 
Physiology. 



Red corpus- 
cles. 

Description 
of their indi- 
vidual vital- 
ity ; proved 

by micro- 
scopical ob- 
servation. 



The globules 
possessed of 
independent 
motion. 



160 THE DOCTRINE OF PURGATION. 



secondly, in the independent movements possessed by the ultimate par- 
ticles of its matter (Lancet, Amer. Edit. 1845, vol. I., p. 214, +). 



Produce:, John, M. D., On the Treatment of Indolent and Irritable 
Ulcers. London. 1844. See Lancet, 1844, Vol. II. 



Ulcers- 
natural out- 



687. I regard the ulcer as a natural outlet or issue for the escape of 

Te a ts.° ut ' certain morbid principles from the blood, the retention or suppression of 

Purre till wn i cn would have occasioned diseases of a more dangerous tendency. . . 

the discharge If the ulcer or the issue emit a disgusting odor and discharge freely, the 

when ea the y y necessity for such a drain is unequivocal ; it cannot be closed without 

iy Xl h£i! ural " r i s k °f a worse disorder. But when the odor of the ulcer, or the issue, 

ceases to be disagreeable, and the discharge is moderate in quantity, and 

of a healthy quality, it admits of cure with perfect safety (Lane, p. 

405). 

Baetlett, Elisha, M. D., Professor of Medicine in the University of 
Maryland; Philosophy of Medicine, Philadelphia, 1845. On' 
the recent Progress and future Prospects of Practical Medicine. 
See Brit, and For. Med. Eev., 1846, Vol. XXII. 

The materia ^88. ^ e Articles of the Materia Medica. — There is probably no 
medica. man more entirely sceptical in regard to their alleged properties and 
virtues than I am. There is no man who has been in the habit of 
using a smaller number of them. My own opinion is, that the number 
of substances endowed with active and peculiar or characteristic reme- 
dial properties is small. . . In many cases of disease all medicines, using 
the word in its common signification, are evils, and that they may be 
dispensed with, not merely with negative safety, but to the actual bene- 
fit of the subjects. . . The golden axiom of Chomel — that it is only the 
second law of therapeutics to do good, its first law being this, to do no 
harm — is gradually finding its way into the medical mind, preventing 
an incalculable amount of positive ill (Rev. p. 237). 



Assist nature 



689. It is coming every day to be more clearly seen that perhaps the 
orietthedis- most universal and beneficial function of medical art consists in the 
removal and avoidance of those agents the action of which is to occasion 
or to aggravate disease, thus giving the recuperative energies of the sys- 
tem their full sc >pe and action, and trusting to them when thus unem- 
barrassed and free for the cure of disease (ibid). 

Btjdd, George, M. D., Professor of Medicine, King^s College, London. 
On Diseases of the Liver. London, 1845. 



Limr-dis- 690. In this countrv mercury has g;enerallv been resorted to, when 

the local symptoms have led to the suspicion that the liver was dis- 
eased; but I fear with no benefit to the patients. It has been well ob- 
served by Abercrombie : " On the liver-diseases of this country, mercury 



ease — and 
mercury, 



blood is ab- 
stracted, Hie 
fewer are 
the chances 



THE DOCTRINE OF PURGATION. 101 

is often used in an indiscriminate manner, and with very undefined Ambiguous 
notions as to certain specific influence which it is supposed to exert faction X 
over all the morbid conditions of this organ. If the liver be supposed mercur y- 
to be in a state of torpor, mercury is given to excite it ; if in a state of 
acute inflammation, mercury is given to moderate the inflammation and 
reduce its action " (p. 99). 

GorEMAN, Edward, Surg., A Collection of Cases of Apoplexy, with an 
Explanatory Introduction. London, 1845. See Lancet, 1845, 
Vol. I. 

691. The following collection of cases is published with the view of A P°vie®y- 
furnishing sufficient data for determining the comparative merits of dif- 
ferent modes of treating apoplexy, and for judging of the expediency fatal 9 
of resorting to bleeding for the cure of that disease (Introduction). 

Here follow 250 cases. 

The conclusion is, that bleeding, generally speaking, is so ineffectual ^ The more 
a means of preventing the fatal termination of apoplexy, that it scarcely 
deserves the name of a remedy for this disease ; that the treatment 
without loss of blood was attended with the most success, and that of recovery, 
the mortality of the disease increased in proportion to the extent to which 
the Heeding was carried ; the more copious the loss of blood the more 
fatal the disease (pp. 198, 199 ; Lane, p. 533). 

Mackin, Charles T., M. D., On the Acute form of Gout, with Remarks 
on its similarity to Acute Rheumatism. In Lancet, American- Edi- 
tion, Vol. I, 1845. 

692. In a well-defined attack of qouk the pre-existing and graduallv Oout;—a, 
progressing derangement of all the organs which subserve the purposes from 
of digestion and nutrition, coupled with the very remarkable increase 0™ *S* 
of nervous irritability observable (as far as my experience goes) inva- i/ve ° r v ans - 
riably antecedent to a paroxysm, are sufficient, in a great measure, to 
warrant the conclusion that it is one of the most prominent examples of 

a local disease, depending solely for its origin on constitutional disturb- 
ance (p. 312). 

693. It is, in the established rules of modern practice, to be taken Modern 
by storm, to be driven from the system " vi et armis," and all the means P ractlce - 
which an already overgrown materia medica places within our reach, 

have been and are brought to bear against it. Patients are cured ; 

" they get well." . . . From the first recipe traced on sand by the staff 

of Anaximander or TJierecydes (the inventors of writing) up to the last ci& ^ p ^: 

" fiat mistura," have we one which we can positively say will produce a ionofhfeart. 

certain and definite effect? No, not one. Medicine is then, as yet, 

nothing save a nice balance of contingencies (pp. 312, 313). 

A knowledge of Brandreth's I'illn would have changed this opinion. 

004. The premonitory signs of its approach are generally to be found The precw- 

of a well-marked and definite character, so much so that in many in- JJXaKS- 

stances he who has undergone a previous attack, can foretell with unci-- 'i;'',, 1 "\, f £% 
11 



162 THE DOCTRINE OF PURGATION. 

tc \tomadt* r i n g certainty the coming of a "fit" as it is termed, some time anterior 
ana intes- to the appearance of the unwelcome visitor. The first symptom which 
removal of excites observation, is a considerable increase of nervous irritability, 
matur° rU &. an d a general peevishness and hastiness of manner. The sleep is restless 
stftute* The arLC ^ unrefreshing, disturbed with frightful dreams, tossing of the limbs, 
cure. etc. The appetite (though not invariably)/^,? off. There is gastroin- 

testinal derangement, with a sense of fullness and oppression subsequent 
to meals ; dyspepsia and heartburn are pretty constantly present. As 
the symptoms become aggravated, the patient is annoyed v^ith. flatulence, 
accompanied with sour eructations. . . . 

There is a bitter, or at all events, a vitiated taste in the mouth, espe- 
cially on first rising in the morning ; headache 'in those of plethoric 
habit ; the bowels are costive or relaxed — in either case the secretions 
are dark and offensive. The urine is of a saffron tinge, often scanty in 
quantity, and charged with lithic acid. These form the more remarka- 
ble prodromata, and, curiously enough, are observed to possess a distinctly 
intermittent character (p. 313). 

— These are, as the author expresses himself in another place, 
" not the ' hints,' but the ' positive directions,' laid down for the man- 
agement of the disease, for our guidance and instruction, by Dame Na- 
ture " (Lancet, A. E., Vol. I., p. 672). 

The last 695. Of the near approach of the "fit" the patient is warned by 

warmng. ^emg seized at intervals with flying or transitory pains in different 

parts of the body, mostly affecting those portions of the frame already 

weakened by previous illness (ibid.). 

Theparox- §§Q m A mos t remarkable fact connected with the disappearance of 

ysm a salu- _ , . .,i,i > i* i • 

tary process the paroxysm is that the patient, with the exception ot being more or 
°cur6. atural less crippled for a time, experiences a sort of general renovation of the 
system, and his state of health is better and more vigorous subsequently 
than prior to the fit. It seems as if the localization of this disease were 
a salutary process instituted by the " vis vitse " for the more effectual 
and complete removal of the cumulative disturbance of the general 
economy (ibid). 

The disease 697. I have also observed that very slight causes will bring about the 
Its ' g appear- development of the elements of gouty inflammation, with xvhich the sys- 
ances local. t m i appears to be charged. I have known so trivial an accident as 
striking the great toe against a stone in walking produce a paroxysm. 
This peculiarity is often witnessed in those who are of confirmed gouty 
diathesis. Indeed, a man constitutionally subject to the disorder ap- 
pears " to wear his heart upon his sleeve," slight accidents, otherwise of 
no moment, being sufficient to induce an attack of this extraordinary 
disease (p. 314). 

Saka, Roberts, Professor of Medicine in the University of Milan. 
Sui Pregi 6 Doveri del Medico. Milan, 1845. 

simplb reme- 698. A physician of no great reputation would positively compromise 
dies t e kj s interests, if he limited himself to the prescription of simple remedies. 



obtain. 



THE DOCTRINE OF PURGATION. 163 

The general ignorance obliges him to be a proselyte of the polyphar- Humbug es- 
macia y and indeed it is very easy to unite to any medicine a greater or "profession.^ 
less number of substances which are quite incapable of modifying its 
properties. And it is also useful frequently to vary the medicines, 
because the public readily disbelieves in the knowledge of a physician 
who always prescribes the same remedies (p. 115). 

699. The principal means of obtaining success in practice is to limit success in 
one's self to a reasonable system of expectation, and to prescribe in cases E^to - 
in which no active medicine is clearly indicated, substances incapable of 
exciting remarkable changes in the animal economy (p. 120). 

Taylor, J., M. D., Clinical Remarks on Cancer. See Report of the 
University College Hospital in Lancet, 1845, Vol. II. 

TOO. The commonest way in which cancer is propagated is by the circu- 
lation of the cancer-cells in the blood, and the arrest of them in the capil- 
laries, when they multiply and form tumors. In this case (the reported "X ye and 
one) there was no ulceration. The organs that are secondarily affected 
by cancer have always some connection with the seat of the primary 
disease. TVe can easily see the connection between cancer in the breast Sea." 
and lungs. In passing through the pulmonary capillaries the cancer- 
cells are arrested, and thus the cancer is formed (p. 602). 

Yog-el, Julius, M. D., The Pathological Anatomy of the Human Body, 
leipzig, 1845. See Brit, and For. Med. Kev., 1846, Vol. XXII. 

701. Gases may be developed in the human body from two distinct Foul gases 
sources — horn food in the intestinal canal in the act of decomposition po S Tti d n ecom * 
and from decomposition of the tissues of the body itself. The gases 
produced in the intestinal canal occasionally permeate through its walls 

into the peritoneal cavity (Rev., p. 324). 

Waddy, J. M., M. D., On Puerperal Fever. See Lancet, 1845, Vol. I. 

702. When the intestines are burdened with fecal accumulations the Effects of re _ 
constitution becomes affected in various ways ; thus cerebral and vis- tained f£KCes - 
ceral congestions, phlebitis, &c, may be the result of pressure on the 

larger vessels. The intestines are distended beyond their tone, and give 
rise to flatulency, anorexia, indigestion, and there is probably absorption 
of putrid matters, which may all tend to promote a highly unfavorable 
state of the general system (p. 674). 



Cancer — 
cells in the 
blood. 



removing 
prevent their 
accumulation 

the arte- 



703. The phenomena of the typhoid and ataxic {nervous) fevers, Fever~\he 
whether common or puerperal, will be best explained as the consequences JJJJtoSffi 
of poison — either generated within or introduced from without — the nate poison. 
fever being strictly an effort of nature to throw off injurious matter 
from the living body (pp. 698, 699). 



164 THE DOCTEINE OF PURGATION. 

Remittents. 704. Remittent and intermittent fevers — the consequence of nature' 's 
endeavors to eliminate a poison from the system by the biliary organs 
(ibid.) 

IMPOKTANT QUESTIONS. 

Rapidity of 705. Does the rapidity of pulse (in fever) depend upon a law of na- 

the puise. ^ure to make up, by rapidity of distribution and change, for a deficiency 
of vital principle in the blood, or is the heart directly stimulated into 
increased action by morbid matter in the blood f (Ibid.) 

Clendinning, Dr., Report to the Royal Medical and Chirurgical Soci- 
ety, January 13, 1846. See Lancet, 1846, Vol. L 

Hydroceph- 706. T. S. .Allen, Surgeon to St. Marylebone Infirmary, has seen in 
more than 500 cases of dtarrhma in children, whose aces varied from 3 



SUPPRHSSED 
DIARRHCEA. 



months to 3 years, that in at least 6 to 1 the diarrhoea was symptomatic 
— a salutary effort of nature to relieve the system — to suppress which, 
by opiates and absorbents, was to invite Iiead-symptoms, hydrocephalus, 
convulsions, and death (p. 101). 

Hall, Marshall, M. D., Practical Observations and Suggestions. 
London, 1846. (+) 

refu|l of g ig* 707. That invariable refuge of the timid and ignorant — the lancet! 



norance. 



* to ~ V * V~V «* *«. — ~ ^. 



Miik-fever- 708. I am of opinion that what is designated " mill 'fever" is fre- 

pS5on y with quently symptomatic of the condition of the mammae. The remedy for 

nature's this febrile state is therefore depletion of the milk-ducts. As a preven- 

^urgaii-mf tion of milk-abscess and milk-fever, and with other hygienic objects, the 

infant should be put to the breast at the moment it is born. If, in spite 

of this, the breasts become in the slightest degree tumid, or febrile action 

is set up, another and a stronger infant should be applied without delay. 

This is nature } s mode of relief, and infinitely more efficacious than the 

application of leeches. . . The patient must take barley-water as her 

sole nourishment, and the bowels must be freely purged. 

Harrison, J. B., Surg., Essays on General Pathology. London, 1846- 
47. (+) 

709. In the first place, it is manifest that the presence of foreign 

become matter in the blood must • induce a state of derangement. In the next 

thr P ee ie diffeT- place, it is equally clear that if the blood do not undergo those changes, 

ent modes. ^Jq^ ft [ s destined to receive during its transmission through the lungs, 

it can no longer preserve its healthy constitution. In the third place, 

the blood itself may be imperfectly elaborated (No. Y.) 



The Mood 
mav 



710. It is well known that the faculty do not themselves take medi- 
have /smaii cines in the same manner that they prescribe them to betaken. They 
own "VeS- have not, it must be owned, that large credence which they require from 
dies * others. There is not with them the regular taking of spoonfuls at stated 

intervals, and the expectancy and confidence of the forthcoming result, 

which they ask of others. 



Medical men 



THE DOCTEINE OF PURGATION. 



165 



Leeson, John, M. R. C. S. E. Liebig's Philosophy applied in the 
Treatment of Functional Derangement and Organic Disease. 
London, 1846. 



Til. There are about four hundred and ten preparations in the 
pharmacopoeia of the Royal College of Physicians. Now, any practical 
man of ten or twenty years' standing must have found that four hund- 
red of these preparations are of little or no value whatever in the treat- 
ment of any form of disease, and that about the remaining ten might have 
assisted him in reducing, at one time or other, cases occurring in every 
department of his practice. Nearly all the waters, confections, decoc- 
tions, extracts, infusions, liquids, mixtures, essential oils, spirits, tinctures, 
have little or no influence over any form of disease, when used as inter- 
nal or external remedies. Many of the mineral preparations are abso- 
lutely injurious in their effects under every circumstance, while the 
retention of other remedies is burlesque and nonsense (pp. 10, 11). 



The phar- 
macopoeia. 



712. Fancy aluminum, antimony, silver, arsenic, barium, bismuth, 
calcium, copper, iron, mercury, magnesia, lead, potassium, sodium, zinc 
(all of which are to be found in the London pharmacopoeia of one hund- 
red years' standing, with the exception of barium and bismuth), as 
medical agents which are yet authoritatively retained, and which have 
been at one time or other plied as sovereign remedies for many invet- 
erate forms of disease, although most of them, if not all, are abandoned 
by every practitioner of standing and experience as the most dangerous 
applications for any kind of medical purposes (pp. 12, 13). 



Metallic 
remedies. 



Magendie, M., M. D. 
1846 



See Lancet, 1816, 



Introductory Lecture in the College de France, 
Vol. I. 



713. When disease requires assistance, we may still by well-judged Assist nature 
intervention assist nature in overcoming the functional derangements by art * 
which gave rise to the disease (p. 238). 



714. Tartar emetic, when brought into contact with the blood, has 
the power of dissolving the globules' ($. 363, citation in the paper of 
Butler Lane, Surgeon). 



Tartar- 
emetic. 



Wilson, J. A., M. D., On the True Character of Acute Rheumatism; 
in Lancet. 1846. (+) 



715. Inflammation is but an expression of the nutritive function 
endered difficult for the time in particular structures. Inflamma- 
tion originates no movement, creates no function, brings no new 
elements into operation; it is not an acquired principle, but an innate 
faculty held in trust by every living structure from the beginning, for 
the means of self-protection, and as a security under injury for redress. 
Thus considered the arthritis of acute rheumatism is respected by the 
physicians as salutary under circumstances, and as working with the 
fever to a cure. 



Inflamma- 
tion — not a 
disease, but 
nature's 
warning. 



Rheuma- 
tisi/i. 



166 



THE. DOCTRINE OF PURGATION. 



Acute rheu- 



Opium and 
lancet ; — 

poison and 
bloodshed 
denounced. 



Localisation 

of fe/vers 
according to 
the poisonous 
matter in the 
general cir- 
culation. 



Disease from 
change in 
the propor- 
tion of the 
natural ele- 
ments of the 
blood. 



The blood 
feels and 
lives. 



716. Opium in acute rheumatism. — The healthy relations of this 
drug with the blood (and it is prescribed on no other indication) are not 
such as to authorize its employment in a disease whose principle of cure 
is one .of unrestrained spontaneous action. 

717. These approved principles of cure by poison and Woodshed rest 
professedly on more than conjectural science for their authority ; they 
are not set forth diffidently, as the experimental, misgivings, by small 
induction, of a theory yet to be realized, but are proclaimed as the 
dicta of a bold and successful experience ; they are blazoned as heroic 
mottoes above the vulgar host, that seeing them we may know our 
leaders and be prepared to follow them. 

718. As the scarlet-fever localizes itself especially in the throat, the 
measles in the mucous lining membrane of the lungs, the epidemic 
typhus in the cmcum and lower ilium, and the erysipelas fever in the 
integuments of the head and face, so is the rheumatic fever determined 
by special effects of inflammation to the larger joints of the body and 
the surrounding articular structures ; but the heat, swelling, and redness 
thus induced are no more the cause of the constitutional disturbance in 
acute rheumatism than the scarlet-rash, or the small-pox pustule of the 
fevers that bear their respective names. They are but the partial 
expression, by impaired nutrition, of a disorder that is general to the 
system. 

719. Assuming the evil was in the blood, not so much from impuri- 
ties as a change in the relative proportions of its necessary elements, we 
might rationally expect the composition of some structures or products 
to be more influenced than others by an excess or deficiency of prin- 
ciples important to their very existence, since the greater frequency 
with which particular parts are affected only indicates that the tissues of 
which they are composed, and the fluids which permeate to them, are such 
as to be especially affected by a morbific cause which prevails to a 
greater or less degree throughout the system. 

720. There is in the blood an independent faculty of sensation 
which by physiologists is not as yet acknowledged. In disease, as in 
health, it is sentient of its own. states, as it is inceptive of its own actions, 
and through it we feel much of what, in idle phrase, is made exclusive 
to the nerve. 



Acute rheu- 
mat sm can 
cure itself. 

Bleeding, 
opium, and 
c.iloniel, if 
they do not 
kill, compli- 
cate the dis- 
order. 



721. The fever of acute rheumatism is competent to the task of its 
own cure. Yet the patient is made to pay by the lancet for its acuteness, 
and swallows every specific for gout and neuralgia in right of his rheu- 
matism. . . From this practice, there is reason to believe that many of 
the dangerous complications so frequent of late years in the pathology 
of acute rheumatism do in truth proceed. In the well known combin- 
ation of opium and calomel, this mischievous diligence of treatment 
receives its most frequent illustration. The objects proposed in this 
heroic formula are the immediate and complete extinction of fever, pain, 
and inflammation. 

It is a rude and empirical practice which seldom succeeds, and fail- 
ing of success is most injurious to the patient ; it has destroyed very 



THE DOCTKINE OF PURGATION. 167 

many who, under less popular and energetic methods of treatment, cuJ^kJari- 
would have recovered. . . °"? 5 An *° the 

There is more wisdom, for there is less cruelty, in homoeopathy, hydro- 
pathy, or animal magnetism. Yet the courage is with those who refuse 
to prescribe. 

Let young medical men ponder. 



patient. 



ity. 



722. Purgation. — Its simplicity ill accords "with the impatient vio- JSSpiiS 
lence and affected combinations of modern therapeutics; yet of consti- 
tutional methods of cure, no one, by long practical experience, has been 
more thoroughly approved. 



Forced 
sweat. 



723. To secure effects by perspiration, opium, antimony, ipecacuanha, 
ammonia, have been unsparingly added to the system, already tasked by 
an active disturbing principle, to its utmost means of resistance. 
Hence, from undue haste, violence, and inconsistency of action, a great 
loss of the credit which would otherwise have attached to the sweating 
practice in rheumatic fever. 

Imperfect sweating causes offensive matters to remain in the ducts 
and pores. 

Sweating to be beneficial must come on spontaneously, with no aid from drugs,, 

Dick, Robert, M. D., The Treatment of Dyspepsia. See Lancet, 
1847. Vol. I. 

724. Cajcum. — In all cases of constipation or torpor of the bowels, cw*-_ 
attention to the caecum is important. It is here that fecal accumulations Sse ? \n~the 
are, on several accounts, apt to take place. The circumstance of the large JjJJJJjigE! 
bowel here forming a cul-de-sac, out of which, moreover, the fecal mat- flammation 
ter, during 14 or 16 out of the 24 hours, can only escape by a course dmTd/^ce's. 
counter to gravity, disposes not a little to the collection there of excre- 
ment. And indeed, in most cases of constipation, in cases of chlorosis, 

&c, we shall generally both see and feel a fullness of this part, some- 
times of remarkable and even alarming extent and hardness. . . . And 
I have no doubt that in not a few cases a state of chronic irritation of 
(sub-) inflammation and even of ulceration of the mucous membrane of 
the caecum, is induced from the long contact with hardened faeces which, 
moreover, have become preternaturally fetid and undergone certain irri- 
tating chemical decompositions. In such circumstances either round or 
irregular masses of a fatty looking substance may often be detected in 
the evacuations. This consists of inspissated mucus, secreted by a sur- 
face highly irritated or {sub-) inflamed. A slight prolongation "or 
increase of such irritation will convert this inspissated discharge into a 
purulent one (Lane, p. 32). 

725. In impure states of the fluids we prescribe purgatives on the The 
following assumption, namely, that if we, by artificial means, afford ^SIT*' 8 
nature trie opportunity, she will, by emunctories whose action we excite, 
discharge herself of morbid principles, retaining those that are healthy. 

This, indeed, is the grand general law, in faith of which we venture, ^n 
any case, artificially to meddle with, nature (ibid. p. 88). 



168 



THE DOCTRINE OF PURGATION, 



Sherwood, John Burdett, M. D., On Dyspepsia. London, 1847. 

Unity of dis- 726. I am of opinion that the proximate cause of all diseases con- 
sists in some alteration in the force, quantity, or quality of the circulat- 
ing fluid ; and that, of those affecting the general system, vitiation of 
the blood is an in/variable accompaniment (Preface). 



Johnson, Edward, M. D., On Dfe, Health, and Disease. American 
Edition. 



New York, 1850. 



*■ Purgation ^27. Purgation, like exercise, accelerates what Liebig calls the change 
accelerates f matter — that is, the daily disorganization and reorganization of the 

the change <\ /•i-i-it -i • i i '77 77 . 

of matter, elements 01 the blood and vital organs, by more rapidly expelling the 
old and worn out material and supplying its place with new (p. 96). 

oid ageytie 728. There is but one legitimate cause of death, and that is old age. 
nSrte le caus«> If an V nian die while any of his organs is unimpaired, he dies pre- 
of death. maturely, and before he has fulfilled the final cause of his existence 

(p. 08). 



729. The health of the body depends upon the healthy performance 
of the nutritive actions, and disease consists in the unhealthy perform- 

mate effects 



IleiiHh and 

disease. 
All the legiti- 
me ance of these- actions, or of one or more of them. Medicines, therefore, 
attained by ] mve no rea i va i ue nor power over disease, excepting as they have the 



■purgatives. 



power of increasing or diminishing the activity of tlie nutritive actions, 
absorption, secretion, circulation, dec. (p. 88). 



n from indi- 730. We cannot derive any benefit from what we eat except from that 
overfeeding portion of it which in due course becomes blood. ^1/^that we eat, there- 
our food does fore, beyond what can be converted into blood, is either changed into fat. 



not become 
blood, the 
system is ^ 
filled with O 
gases, etc 



i' is left in the stomach and bowels to run into fermentation, serving no 
tlier purpose than to distend these organs with all sorts of pernicious 

and offensive gases (pp. 81, 82). 



digestion — 
(constipa- 
tion) — how- 
it impover- 
ishes and 
poisons the 
blood. 



Good illus- 
tration. 



731. The result of improper digestion is that the necessary change 
which should be wrought upon the food in order that it may nourish our 
bodies, is very imperfectly effected — the chyme is of unsound quality. 
The next result is this : the chyme, by admixture with certain other 
juices which it meets with in the bowels, is destined to become chyle. 
But the chyme being of vicious quality, the chyle which is formed from 
it must also be vicious. At all events it must be deficient in quantity ; 
certainly it is impossible to suppose that as much perfect chyle can be 
elaborated out of bad chyme as of good. You might as well hope to 
make as much good butter out of bad cream, or out of cream and water, 
as oat of pure cream. The chyle, therefore, is deficient in quantity; 
but this chyle is destined to become blood. The chyle, therefore, being 
deficient, the blood resulting from it must also be deficient (p. 125). 



TheMood 
the nutri- 
ment of the 
body. 



732. But the blood is in fact the real food on which the body feeds, 
and this food being scantily supplied, the strength of course is ill-sup- 
ported. But there is another mischievous result of this condition of the 
stomach and bowels, beyond that of unhealthy and deficient gastric 



THE DOCTRINE OF PURGATION. 



109 



juice. In that condition of the health which I am endeavoring to 
describe, the stomach aud^ bowels actually secrete air. It is a thoroughly 
established fact that air-wind— flatus — is actually formed from the blood, ed^^Tits 
and poured into the stomach and bowels by those arteries which ought eff ects. 
to form only gastric juice. Now, this wind not only does no good in 
the stomach and bowels, but it does a vast deal of harm. For, besides 
the evil effects which it produces by its pernicious qualities, it violently 
distends these organs, stretching and separating, and thus greatly iveaJc- 
ening and destroying the firmness and compactness of their ultimate 
tissue (pp. 125, 126). 



William, M. D., Observations Relating to the Science and Art 



Wegg 

of Medicine 



London, 1851. 



733. A highly important action of 'medicines upon the intestinal sur- 
face remains to be noticed, as affecting its excretory function. I do not 
mean the process which eliminates from the villous surface a fluid largely 
composed of water, containing the remains of the epithelium, &c, and 
which almost any irritating cause may excite, but the excretory function 
of the glands which thickly stud the surfaces of the bowels, and espe- 
cially those of the large intestines. Although the lungs, liver, kidneys, 
and skin contribute largely to the depuration of the body, there is little 
doubt that these glands contribute greatly to the same result, very proba- 
bly by expelling matter different from that which those other depurating 
organs eliminate (p. 213). 



Purgative, 
medicines — 
their action 
on the colon. 



EEaspel, A., M. D., Medical Staff of the Algerian Army. 
Paris, 1852. See Med. Chlr. 



VAlgerie. 
Vol. X. 



Be v., New 



Maladies de 

Sen, 1852, 



734. In this season of the year (autumn in Algiers) every individual 
seems to be endowed with an especial susceptibility to the development 
of typhoid symptoms, when he becomes the subject of dysentery, inter- 
m Ittent or remittent fever. But these accessory phenomena, the stupefied 
countenance, the restlessness., heat of the belly, &c, quickly disappear, 
at the same time with the principal disease, under the influence of an 
evacuating plan of treatment. We must distrust the fulness of pulse, 
the false plethora, which manifest themselves during the prevalence -of 
the great heats, and which seem to call for bleeding. If we yield to this 
perfidious indication, we find our patients fall into a state of adynamia, 
without the dysentery undergoing any amendment ; or, if the abstraction 
of blood produce any relief, it is but temporary, to be speedily followed 
by a sensible aggravation of all the symptoms (p. 58). 



Malignant 
fevers 
abound. 



Purgation 
the cure. 



Bleeding 
kills. 



735. Mr. Haspel refers to the advantages derivable from purgatives, 
recorded by the. old writers, and considers that their disuse in recent 
times has arisen rather from the prevalence of theoretical views of the 
inflammatory nature of diseases than as a result of experience. 

He speaks highly of emetics at the very outset of these diseases (pp. 
9, 11, 39 ; Rev., pp.' 106 sq.) 



Theory and 
practice. 



resists all 

CONTAGION 



170 THE DOCTRINE OF PURGATION. 

Carpenter, C. William B., M. D., Principles of Humcm Physiology. 
London , 1853. 

Purebiood 736. I firmly believe that if the blood of a person of sound constitu- 
tion be kept in a state of perfect purity by the moderate use of whole- 
some food and drink, by the respiration of pure air, by adequate exer- 
cise not pushed to over-fatigue, and by personal cleanliness, he is as 
completely protected against the invasion of cholera as he who has been 
effectually and recently vaccinated is proof against small-pox. . . The 
same is true of all contagions and diseases, and hence the universal value 
of purgatives, which quickly restore the above conditions, if any aber- 
ration has taken place (chap. IV.) 

Dickson, Samuel IT., M. D., Professor Med. College of South Carolina. 
Elements of Medicine. Philadelphia, 1855. 

?ow & n°bt~ ^37. The blood is often indirectly poisoned by the influence of con- 
comes im- tingencies which prevent the elimination of such effete matters as must 
siTeV dis- be got rid of to keep it in a normal condition. We have reason to infer 
eased). ^ e existence within it of injurious ingredients, whose presence we can- 
not demonstrate by the ultimate results. The blood may thus become, 
so to speak, passively diseased (p. 111). 

and^fflSJJS ^^- ^ n ^ ne cure °f i n fl uen z a , purgatives aid in reducing to its proper 

twes. level the vascular excitement; while we "derive" from the head and 

throat by determining to the gastric intestinal surface (p. 313). 

The wood— 739. The blood is found altered in disease:. 

it W beJomes 1- ^7 a change in the proportion of its constituent elements ; 

impure. 2. By the addition of foreign matters (p. 111). 

Demands careful attention. 

ei^matteVs ^^' ^ g rea t variety of foreign matters may be absorbed into, mixed 
chymists with, and detected in the blood. Kramer found in it silver, after the 

\nthellood. nitrate and chlorate had been taken. (Esterlein discerned globules of 
mercury in it, as well as in the saliva and urine of persons who had been 
taking mercurials. Heller found iodine and bromine in the blood of 
patients to whom these remedies had been administered. Nitrate, hy- 
driodate, and carbonate of potass, antimony, and carbonate and sulphate 
of iron have been found in similar circumstances. Quinine may be dis- 
covered in the urine, which it must reach through the vessels / and lead 
is shown in the gums and in the brain of those poisoned by that metal 
■ (p. 111). 

CONSEQUENCES. 

other impu- 741. The foreign matters which, as causes of diseases, enter the blood, 
are not always, however, to be thus exhibited by chemical tests and re- 
agents; but their presence can be inferred as indisputably though less 
palpably. . . Blood thus poisoned becomes in its turn poisonous. The 
glands are irritated by it, and the secretions and excretions become mor- 
bid (p. 112). 



THE DOCTRINE OF PURGATION. 171 

742. The sugar excites the kidney into diabetes, the carbon and urea . various 

i -i • M Tj. i • • i i ,• ,1 . • forms of dis- 

oppress the brain with coma. Its chemico- vital relation to the tissues ease induced 
undergoes essential changes, and infiltration and exudation, congestion, ties.™"®"™" 
dropsy, and hemorrhage follow. It ceases to be nutritious, and atrophy 
and marasmus follow, or its nutrition is perverted and morbid, and we 
have hypertrophy, or deposition of scrofulous, tubercular, typhus or 
cancerous matter (ibid.) 

Bennett, John Henry, M. D., Editor of Edinburgh Medical and 
Surgical Journal. 

743. The mortality from pneumonia has diminished since large Bleedin in 
bleedings have been abandoned. (Present state of theory and practice pneumonia. 
of medicine. Journ., Yol. I., 1856, p. 19.) 

744. Pericarditis. — Some few years gone by, the practice was to Perimr- 
meet the violence of the inflammation by the extremest antiphlogistic 
measures ; the lancet was plied with a most unsparing hand, and with 

the most unhesitating faith in the propriety of its use. But where are Blood]ettin 
the believers in, or imitators of, such a practice now ? This " heroic and and mercury 
certain method," as it was called, of arresting the destructive agent — of condenmed - 
exterminating the disease — has been convicted of error, and condemned 
by a late authority as " uncertain and very dangerous." Again : " after 
blood-letting, rapid induction of the mercurial influence is of the greatest 
consequence," wrote an authority in a most unhesitating style some fif- 
teen years ago. But now we find one of the most observing and practical 
physicians* among us admitting, that the firm faith which he himself 
once reposed in the efficacy of the remedy had been undermined by the 
truth-telling effects of further experience. In short, "the errors and 
absurdities," says Dr. Markham, " into which men have been led through 
this hastening to be wise — the fallacious and extraordinary proceedings 
in practice it has involved them in — he who is desirous of learning will 
find recorded on every page of the history of medicine. By thus casting 
dust in the eyes of others, and perverting our own wisdom, we raise up 
positive barriers to the advance of true knowledge ; for now the mist of 
delusion which our faulty haste has generated must be swept away 
before the honest face of the simple fact can be made available to light 
our slow steps along the difficult passes of new knowledge (Journ., vol. 
I., 1856, pp. 1038, 1039). 

745. The very discordant opinions which equally honest and equally Medical 
skilled observers maintain — observers not living in separate ages, or in HKJHS^ 
different countries, or in separate cities, but exercising their art upon ' stubbom - 
the same disease, under the same roof, in the same public hospitals — 

must have a meaning. Is it not one which is oftener than we care for 
to confess, responded to by our consciences at the bedside of the patient ? 
(ibid., p. 1039). 



* W. 0. Markham, M. D., in his "Diseases of the Heart, their Pathology, Diagnosis, 
a"nd Treatment." London, 1856. 



novo.' 



172 THE DOCTRINE OF PURGATION. 

inflamma- 746. ISTone but men ignorant of pathology now talk of " knocking 

tS'weed- down " inflammation with blood letting, or with mercury. Indeed, why 
cu?y cu™s!" these remedies are employed at all, has, to use the word of Dr. Mark- 
ham, " yet to be shown " (ibid., p. 1042). 

Bennett, J. Hughes, M. D., Professor of Medicine m the University 
of Edinburgh. Observations on the Results of an Advanced Diag- 
nosis and Pathology, etc. Edinburgh, 1856. See Edestb. Med. and 
Surg. Journ., Vol. L, 1856. 

Pastexpe- 747. Medicine is not a scientific art, which is dependent for its 
theories— of principles on the study of and commentary on the older writers. . . On 
n me U dfcai n the contrary, it is the book of n/itwrn, which is open to all, that we ought 
SS- to P eruse an d study; and why should we read it through the eyes of the 
begin "de sages of former times, when the light of science was comparatively 
feeble and imperfect ? . . . The lesson which a careful study of the 
history of medicine has forced upon me, is the necessity of reinvestigating, 
with all our improved modern appliances, the correctness or incorrect- 
ness of existing dogmas, in order to establish an improved practice for 
the future (Propos. I. ; Journ., p. 773). 

Smaii-pox. 748. Dr. Wm. Addison (Cell-therapeutics, 1856) correctly points out 

The pustules that in the distinctive eruptive fevers, such as small-pox, the numerous 
—the matter small abscesses in the skin eliminate the morbid poison, which formerly 
creted^m existed in the blood, and are in this way essential to the cure. This 

provident action he denominates " Cell-t/ierapeutics." In all such cases 

experience has shown that time and a natural sequence of changes is 
is injurious" necessary for a restoration to health, and that the idea of cutting short 

such changes by bleeding is alike erroneous in theory and injurious in 

practice (Propos. III. ; Journ., p. 777). 

— tne^thetr 6 ' ^^' ^ ar g e an d early bleedings have been practiced under the idea 
far more ap- that by diminishing the amount of the circulating fluid — 
pwgJion. 1. The materies morbi in the blood would be diminished y 

2. Less blood would now into the inflamed parts ; 

3. That the increased quantity of blood in the parts would be les- 
sened ; and 

4. That the character of the pulse was the index as to the amount 
of fluid that ought to be drawn (ibid. ; Journ., p. 776). 

B mo e ves S thT ^0. The careful investigations of chemists, and especially those of 
good^ and Andral and Gavarret, Simon, Becqueril and Rodier, and others, have 
further shown us, that whilst venesections greatly deteriorate the blood, 
rendering it poorer in corpuscles and richer in water, they have no effect 
in eliminating morbid products, and that in the vast majority of cases 
elimination is impeded by blood-lettlng (ibid. ; Journ., p. 778). 



the blood. 
Bloodletting 



allows the 
bad to re- 
main. 



Liflamma- 751. Inflammation having occurred, the great work now to be accom- 
%S/-«/and plished is to break up the exudation that has poured out, to remove the 
uve cure lie pressure it exerts on the nerves and blood-vessels, and render the whole 
same. capable of being eliminated from the economy, either directly, by dis- 

charge externally, or indirectly, first, by passage into the blood, and 
secondly, by excretion -through the emunctories (ibid. ; Journ., p. 779). 



THE DOCTRINE OF PURGATION. 



173 



Inflamma- 
tory action 
described — 
bloodletting 
useless — in- 
dication for 
purgatives. 



752. Now, it requires to be shown that draining the body of blood 
cannot in the slightest degree influence the congestion in the inflamed 
part. There the vessels are enlarged, the current of blood is arrested, 
the blood-corpuscles are closely aggregated together and distend the 
vascular tube, and are in no way affected by the arterial current, even 
when increased in its neighborhood. That opening a vein can alter this 
state of matters is scarcely to be conceived ; and if it could, how would 
this assist in removing the exudation which has coagulated outside the 
vessels ? (ibid. ; Journ., p. 780.) 

753. So far from getting rid- of inflammation by weakening the pulse, 
we not only fail to do so, hut prolong the time for the transformation of 
the exudation. This, indeed, is acknowledged by Louis, Chomel and 
Grisolle^ who distinctly show that the progress of a pneumonia is never 
shortened by bleeding (ibid. ; Journ., p. 781). 

754. It is injurious to diminish by bleeding the nutritive processes Bleeding 
themselves, when they are busily engaged in operating on the exudation, recovery. 
•and eliminating the morbid products (ibid. ; Journ., p. 781). 



Bleeding 
prolongs 



755. The phenomena of fever and excitability following inflamma- 
tion, have been wrongly interpreted. In themselves they are sanative, 
and indicate the struggle which the economy is engaged in, when at- 
tempting to get rid of the diseased processes ; and we only diminish the 
chances of that struggle terminating favorably, by lessening the vital 
powers at such a critical juncture (ibid. ; Journ., p. 782). 



The crisis 

must not be 
interrupted 
by bleeding. 



756. Assuming it as granted that in some cases the pain is for a time 
relieving by bleeding, and that in pneumonia the respiration tempora- 
rily becomes more free — at what cost are these advantages obtained, 
should the patient be so weakened as to be unable to rally % Even if he 
does rally, a large bleeding almost always prolongs the disease (ibid.). 



Bleeding a 
dangerous 
palliative 
which pro- 
longs the 
disease. 



757. Clinical Lectures on the Principles and Practice of Medicine, turn of the 

lungs. 



New York Ed., 1860. 

In all hepatization, the object of nature is to reconvert the solid exu- 
dation once again into fluid, whereby it can be partly evacuated from 
the bronchi, but principally absorbed into the blood, and excreted from 
the economy. Gradually the solid amorphous mass is converted into a 
fluid crowded with cells. This is pus. The cells, after passing through 
their natural life, die and break down, whereby the exudation is again 
reduced to a condition susceptible of absorption through the vascular 
walls, and once again mingles with the blood, but in an altered chemical 
condition. After undergoing various changes in the blood, the exudation 
is finally removed from the economy (pp. 265, 266). 



The natural 
and the pur- 
gative cure 
the same. 



Pickfoed, J. II., M. D. LLygiene. London, 1858. 

758. Malaria is modified by altitude. If the elevation be consider- Dilute the 
able, the temperature will necessarily restrict the fever to the intermit- im P urit y und 



174 THE DOCTRINE OF PURGATION. 

the cUseMe ^ en * f° rm 5 whilst in the plain beneath, the same noxious emanations 
would produce, in tropical climates, remittent or yellow fever, plague 
or pestilential cholera (§ 966, p. 172. Cf. Brown). 



576,000 
rea ons for 



amount 
analogy with 



759. A healthy adult respires twenty times in a minute, and takes 
purgation into his lungs, at each respiration, twenty cubic inches of air, or 576,000 
eptdemfcs, cubic inches in twenty-four hours. This respired air comes into contact, 
maiari' at each inspiration, with 201,600 square inches of mucous surface of 
influences, air-passages and cells. Is it, therefore, matter of surprise that atmos- 
pheric air, contaminated by infectious or contagious matter, or poisoned 
by malarious, miasmatic or paludal emanations, should exert its baneful 
influence on the blood and on the organic nervous system, through the 
nerves distributed to the enormous superficies with which it comes in 
contact at each inspiration % The wonder is, that any of us escape ! 
(§932, p. 165.) 

insensible 760. The sum of the cutaneous and pulmonary secretions amounts, 
%Z^Ats according to the best authorities, to two pounds, eleven ounces, three 

drachms, and twelve grains in twenty-four hours. The cutaneous 
mine! exhalation is a true secretion from the blood, somewhat analogous to that 

of the urine, of those matters which, at the tern per ature of the body, 

are capable of assuming the gaseous form, as carbonic acid and water 

(§§ 1101, 1102, p. 206). 

Hazard, Thomas R., of Vaucluse, R. I. Purgatives. 

761. Doctors' and undertakers' fees are so high that it is very incon- 
venient for persons of small means to be sick or die in these times. 
That most of the maladies that prevail in our climate may be prevented 
by proper care I have no doubt ; and that most of the sicknesses that 
do occur may be cured at a trifling expense and loss of time, I am, after 
half a century's observation and experience, equally certain. I think 
men and women would now. survive to the average age of seventy, 
instead of half that term of years, if they would live and practice in 
harmony with the laws of their being ; which, like all [Nature's works, 
are ever found to be as simple as they are grand, when understood. 

762. Moses was inspired to utter a great truth when he declared 
that " The life of the flesh is in the blood." Action is life ; and the 
blood is the organ by which it is communicated to every member of the 
body. It follows that if the organ be out of tune, the music or har- 
mony of life cannot be complete, however cunningly it may be piped 
upon. If there is discordancy in the instrument, it is not the fault of 
the law — which is ever perfect in itself — but it is the fault of man's 
animal propensities that transgress the law. 

763. The blood that imparts life and nourishment to the system 
feeds upon the food we eat, the fluids we drink, and the air we breathe. 
To preserve its purity we should eat to live, rather than live to eat. 
Eat slowly, chew the food well, drink sparingly, even of water, and be 
temperate in all things, and one half of the primary causes of disease 



THE DOCTRINE OF PURGATION. 175 

will be removed. Hilarity and cheerful conversation whilst at the table 
greatly assists digestion. A hearty, prolonged, explosive laugh will 
well nigh split a pine-knot on its passage to the stomach. 

See to it, as far as is practicable, that you breathe un contaminated 
air ; for every breath we draw comes in contact with the blood, and 
imparts to it its own quality, whether it be the savour of life to life or 
of death to death. Look especially to your sleeping-rooms that they 
are daily (and if small nightly) ventilated. Avoid beds, and particu- 
larly pillows, that are filled with blood-shotten feathers. Keep the 
pores of the body open and clean by frequent bathing, for each of these 
are pipes that gives tone to life's organ. Above all things look to it 
that there is no decaying vegetable matter of any kind near or under 
your sleeping apartments, for probably more sickness occurs from this 
cause than any one other. If at any time you begin to feel dull and 
heavy and good for nothing— -if you lose animation, and your flesh feels 
numb and sore ; if your mouth grows clammy, and your tongue furs / 
if your eyes feel as if they had sticks in them, or your head, or side, 
or back. begins to ache, or old sores and weak points of the system 
grumble ; if you snuffle, or your voice grows husky, accompanied with 
a hacking as if to clear the throat — lose no time in ascertaining and 
removing the local cause, if possible, before you are stricken down by 
disease. Proceed first to your cellar, especially if you sleep on the 
ground-floor. Examine it well in every nook and corner. You may, 
in your researches through its dark labyrinths, perchance stumble upon 
a dead cat, and perhaps some festering rats ; but heed them not. Their 
aroma is not pleasant, but it is not deadly poisonous ; but, if you should 
fall in with a rotten turnip or potato, or cabbage, or any other decom- 
posing vegetable, eject it at once a stone's-throw from your house, with 
every vestige of its remains, even to the earth it has impregnated ; for 
the miasma that arises from a peck of decomposing vegetables of any 
kind, if inhaled into the lungs, and consequently blood, especially 
during sleep, is sufficient, with the aid of the lancet or of a little 
morphine, to kill a regiment of hardy men, and the stronger and more 
robust they are the more certain will be their doom. I have myself 
known, many years since when the lancet was in vogue, scores of hardy 
young men and women perish under si*ch circumstances in a single 
country town of this State, whose lives might have been easily saved, 
I am entirely confident, under a different mode of treatment. I have 
now in my recollection a certain Doctor Sangrado, who then practiced 
in that town, of whom it might with truth be said " Death followed 
after him." He seldom entered a family at the season of year when 
these morbid attacks were most rife, without sending one, two, or three, 
and even five in one instance, to their graves. Weakly patients, whose 
strength of constitution was not competent to carry any considerable 
portion of morbid matter in their blood before it gave way, stood some 
chance of life under the bleeding treatment of that day, but those of 
strong constitutions stood but little. These, when attacked, generally 
kept about until their blood became so thick and sluggish that it 
coursed with difficulty through the thousands of little ducts and vessels 
tli at carry life to the surface and extremities of the body, and were 
unconscious of their danger until the morbid matter in the blood — 
precipitated perhaps by the scratch of a briar or pin, or a draft of cold 



176 THE DOCTRINE OE PURGATION. 

air or other trifling exposure — began to clot or congest in the intricate 
recesses of the brain, the liver, the pleura, or some other weak or deli- 
cate point, accompanied, of course, with pain or distress. Dr. Sangrado 
was then called, who proceeded at once to draw a heavy portion of the 
best blood from the system in order to relieve the suffering ; and, 
having thus paralyzed the vital forces, they were next stimulated by a 
dose of mercury and expected to perform double duty, with their 
instrument (the blood) just crippled by the lancet. In other words, the 
horse that was striving, with all his might, to extricate a heavy load 
from the mire was first knocked on the head to prevent his injuring the 
wagon by his efforts, and then a shoulder was placed to the wheel in 
the vain expectation that the additional stimulus would enable the 
dying steed to drag it through the mud. The loss of the best blood 
the system could afford neutralized the otherwise good effect of the 
mercury, gave momentary relief to the patient just so far as life had 
been obstructed, relaxed the efforts that Nature was making to dispel 
the poisonous miasma from the blood which, in its weakened" flow, went 
on congesting or clotting with accelerated speed. The pain or distress 
soon returned, and again the lancet was resorted to, alternately with 
doses of calomel, until the patient's whole body, deprived of its life- 
principle, became a mass of inert and putrid matter; and "Died of 
typhus fever " was generally the verdict of Death's coroner. 

764. The practice of blood-letting has been, finally, pretty much 
abandoned, and one less revolting, but little less fatal in its operation, 
has been substituted by many physicians in its place, viz. : that of 
relieving effects at the expense of aggravating the cause by the use of 
opium. Instead of knocking the horse on the head under the circum- 
stances before narrated, his efforts are paralyzed before the shoulder is 
put to the wheel by dosing him with poison. 

765. To illustrate by another homely comparison : If a piece of 
cloth be run through water saturated with fustic, logwood, or other 
dye-wood, it will come out stained or colored. Rinse this in a brook, 
and the coloring-matter will quickly disappear; but drop a small lump 
of alum, vitriol, or other mordant in the dye- vat before the cloth is 
passed through it, and all the water of the lakes will not suffice to wash 
it white again. So, when the blood, by neglect, exposure, or abuse, has 
become surcharged with unhealthy matter, sufficient to interrupt its 
healthy flow, and begins to clot or congest, a little stimulus applied in 
the same direction that the law of our nature is already striving to 
impel the vital forces, will enable them to dislodge the congestion and 
expel the morbid matter from the blood. But introduce an opium pill 
or the smallest portion of morphine into the blood, and all the mercury 
or other cleansing stimulants on earth will scarcely purge it clean. 

766. A bullock's hide once accidentally lodged on a shoal (Veak 
point) in the River Tiber — the great artery of Rome. Against this the 
impurities and drifts of the river gradually congested, until it became a 

ast-anchored island. When first deposited it is probable a housewife 



THE DOCTRINE OF PURGATION m 

might, with a mere swash of her broom in the direction of the current, 
have so far stimulated its force as to have removed the hide (congestion) 
and prevented the formation of the island. 

767. Before applying such a mercurial remedy, to be consistent 
with his practice as applied to the cleansing the channels of the blood, 
Dr. Sangrado would have first withdrawn from the Tiber sufficient 
water to nave left the bullock's hide high and dry in the sand, and then 
set the woman to work with her broom ; whilst Dr. Morphina should 
have advised that the swashing process should be deferred until the 
waters of the river were congealed by frost, or thickened by some 
ingenious process to the like consistency imparted to the blood by opium 
or other narcotics. 

768. What I have said so far is mostly theory, which readers will, of 
course, estimate at what it is worth. What I am now about to say is 
fact, derived from more than thirty years' observation and experience 
applied to multitudes of cases with, as far as I am advised, uniform 
success, including bilious colic, bilious fevers, and all that class of mala- 
dies that, under the ordinary medical treatment, end in slow fevers 
called in the books Typhus or Typhoid, Pleurisy, common colds and 
sore-throat, Indigestion, and its first-born child Headache, Croup (if ap- 
plied in an early stage), Dysentery, Diarrhoea, Fever Sores, and running 
sores generally (the fountain of which is ever the blood), cuts and bruises 
of the flesh (if applied immediately after the accident occurs), and, in 
fact, almost every acute ailment common to our climate, that commences 
with pain in the head, body, or limbs, or at the commencement of which 
the patient remarks, in a languid tone, " I donH feel well" with the 
exception, perhaps, of scarlet and lung fevers, which the remedy I shall 
describe greatly benefits, and lays the foundation for a certain cure, as 
far as my limited experience in these complaints extends, by applying 
additional simple treatment, viz., packing in the former, and certain 
vegetable cordials or decoctions in the latter complaint. 

769. At a period when the reputation of the Mood-letting physician 
I have referred to was at its height (and it was great in proportion to 
the scores of his victims that died, those that recovered being held in 
popular estimation that his skill had miraculously rescued from an other- 
wise mortal distemper), a hired girl living in my father's family was 
smitten with the usual symptoms of the prevailing malady, and Doctor 
Sangrado was sent for. He told my father that the girl's case was ex- 
ceedingly dubious, that her organization was unfavorable, and that Ire 
had but little hopes of her recovery ; still he would do all that medical 
skill could do to save her life. My father was opposed to blood-letting, 
and the doctor deferred the use of the lancet until the next day. In 
the meantime my father gave the girl a dose of what was then known 
as Aldrich]s Pills, accompanied with a sweat. The next afternoon the 
doctor called again, and, after sitting a little while, inquired after the 
girl's health. My father told him what had been done, and that she 
was then apparently well and at work in the kitchen. Upon this an- 
nouncement the doctor mused a few moments, and after remarking in 
a soliloquizing tone that " those pills are devilish things," he took up his 



178 THE DOCTRINE OF PURGATION. 

saddle-bags, lancet, blue pills (sure to be followed by rheumatism), 
opium, mercury, blisters and all, and departed, " never to return" 

770. About this period manufacturers in the town alluded to, of 
which I was one, were seriously incommoded by the annual prevalence 
of the complaint, dubbed by Sangrado as typhus, but popularly known 
as fall fever. Business was sometimes brought nearly to a stand-still 
from the number of hands that were taken out of employ in consequence 
of long, and, in very many cases, fatal sickness. A young man or 
woman would leave the mill, complaining, perhaps, of a pain in the 
head, neck, shoulders, back, or side, or difficulty in breathing, send for 
Doctor Sangrado, experience momentary relief from the free use of the 
lancet, and, in consequence, be prostrated on a bed of languishing for 
weeks or months, and probably die. I was fully satisfied, in my own 
mind, that both the sicknesses and deaths were, in a great majority of 
cases, the result of improper treatment, rather than the normal character 
of the malady, and greatly to the disgust of Dr. Sangrado, gave free 
and wide utterance to my convictions. I finally resolved to practice 
medicine myself, so far as I could obtain patients, from among those in 
my immediate neighborhood and employ, gratis ; and from that day to 
this, a period of more than thirty years, out of many hundreds of cases 
of almost every type of disease, I have never known a death to occur 
among those who have relied solely on the simple remedies I have fur- 
nished, nor have I known of a serious case among them all of Dysentery, 
Pleurisy, Typhus or Typhoid, Brain, Congestive, Bilious, or any other 
fever, except scarlet or lung fevers, of which last, as before said, my 
experience has been slight, and confined to my own family, in which 
there has been five cases of scarlet fever ; one of which was treated by 
two of the most renowned physicians in New York, and died in great 
apparent agony on the seventh day. Two of the other cases were 
equally severe, but all recovered without the interference or aid of the 
faculty. 

771. For some time I relied on the " devilish pills " only in light at- 
tacks, and gave from 12 to 15 grains of calomel, with a good sweat in 
severe cases. I generally attended to the sweating process (which I shall 
hereafter describe) myself; and never, to my recollection, failed to obtain 
the desired sweat. The mercury stimulated the interior powers of the 
system, whereby the morbid matter is (as I suppose) forced from the blood 
into the bowels, and thus passes ofl'; whilst the sweat, operating on the 
external pores of the body, in like manner as the stimulating mercury 
acts on the internal pores or ducts, the two forces sympathize and assist 
each other ; and the congestion and other causes of disease (unless it has 
become chronic) are wholly expelled at one operation, leaving the system 
as free from poisonous or unhealthy matter as is that of a new-born 
babe. 

772. It is now nearly thirty years since I entirely abandoned the use 
of calomel, for which I substituted " Brandretli's Pills," which I have 
found, after long and varied experience, produce all the good effects of 
mercury, with none of its bad. Too much care cannot, however, be ob- 
served in obtaining them, as a large proportion of the pills sold in New 



THE DOCTRINE OF PURGATION. 179 

England are spurious, notwithstanding their close resemblance to the 
genuine and the oaths of the unprincipled men who vend them. To 
make sure of the genuine, I always obtain them from Dr. Benjamin 
Brandreth's own office, which is at the " corner of Broadway and Canal 
Street, New York," and who sends them to order, free of charge for ex- 
press, for two dollars per dozen boxes. One or two boxes (or not over 
twenty-five cents' worth) sufficing generally to keep a family of ordinary 
size in health for a year. 

773. Thus any man, by an expenditure of two dollars, may keep his 
own family, and those of some five or six of his neighbors, in health for 
a year, and that with very little if any loss of time, and not a farthing's 
expense for medical aid. This, as a general rule, I pledge my word I 
know to be true by actual practice and observation — although I suppose 
it will not be so regarded by most readers. These pills are as efficacious 
in cases of hurts, bruises, cuts, sores, &c, as in other maladies. By im- 
mediately cleansing the blood they remove all danger of lock-jaw, fester- 
ing sores, or congestion of the blood, at the wounded or ailing points — 
and nature speedily restores the injured parts. Not unfrequently, from 
the use of opium in some of its varied forms, or other malpractice, the 
morbid matter in the blood seeks to escape through vents called fever- 
sores. I have known instances of this kind wherein, after the patient 
has been in acute pains for weeks, a few doses of Brandreth's Pills have 
turned this current of morbid matter from the sores to the bowels, 
through which it has been passed off, and the patient healed almost at 
once. But I do not mean to be understood to say that this is the rule ; 
as when the system has been surcharged and weakened by poisonous and 
stupefying drugs, nature's vital forces cannot always be rallied by any 
treatment that I am acquainted with. 

774. I will close this long (and, as doctors will doubtlessly say, ab- 
surd and foolish) article, with a simple recipe, which, if adhered to in all 
its requirements, I know will heal at one operation a great majority of 
the ills we are liable to in this country, and I believe in all other coun- 
tries. 

775. I know that it has been used with entire effect in cases of yel- 
low fevers; and I now have in my possession a certificate, signed by 
every member of a company who were nine months in the Army of the 
Potomac, at a time when thousands were dying around them with 
small-pox, and swamp fevers, and dysentery — the health of every one of 
whom (without an exception) was preserved, without the aid of a physi- 
cian, simply by relying solely on " Brandreth's Pills," a quantity of which 
had been presented to the Company, with directions for using them, by 
their fellow-townsman, Dr. Benjamin Brandreth. 

EECIPE. 

776. In cases of slight hurts, cuts, bruises, punctures, &c, or slight in- 
disposition, take from one to six Brandeetij's Pills, according to age and 
constitution; say one pill for a child one year old, two for a child of 
three years old, and four or more for adults. 



180 THE DOCTRINE OE PURGATION* 

777. Where any malady has made such progress as to cause difficulty 
of breathing, oppression, or severe pain in any part of the body, head or 
limbs, place the feet of the patient in water as hot as it can by any pos- 
sibility be borne, and throw a blanket over the knees to keep in the 
steam. Do not let the feet remain in the bath to exceed four minutes. 
Wipe the feet dry as quickly as possible, and rub them hard with a dry 
towel. Then get at once to bed, and take from one to six pills as above. 
(In cases of intense bilious colic or pleurisy, give six, eight, or even 
more, until relief is obtained, but by no means attempt to remove the 
pain at the expense of the life by blood-letting or narcotics.) After 
swallowing the pills, drink a glass of weak lemonade (or molasses and 
water, if lemonade is not to be had) made almost boiling, and so hot that 
it can only be taken in sips ; then cover warm and a sweat will shortly 
ensue. This treatment will set all the vital forces of life to work, both 
internal and external, and not only remove the effects but the cause of 
the distemper, as the most ignorant cannot fail to perceive, not only by 
the relief that will be experienced, but from the offensive character of 
the matter that passes from the bowels, a large portion of which proceeds 
from the blood, liver, or other vital intestines. Water-gruel alone should 
be taken for eighteen hours after taking the pills, after which, as far as 
my experience has extended, patients, as a general rule, will be restored 
to complete health, and in a situation to eat and exercise as usual, with- 
out danger of relapse, for the simple reason that the blood, the seat and. 
organ of life, is freed from all impurities, and consequently there is 
nothing in the system to cause a relapse ; nor can sickness again ensue 
until the blood again becomes surcharged with extraneous and morbid 
matter. 

778. Some readers may possibly suppose that, in accordance with 
general usage, I may have some interest other than that of a desire for 
the good of others in recommending "Brandreth's Pills" (which, by the 
by, are always inclosed in a certificate and directions folded around each 
separate box, with a government stamp on the envelope). For the benefit 
of such readers I will just say, that I have never received from Dr. 
Brandreth or any other person a farthing for anything done by me in 
relation to his pills ; that I have always paid full price for every box I 
have had ; that I have never received a farthing for any disposition I 
have made of them, although I have probably administered and given 
away hundreds of boxes — that I esteem a judicious distribution of them 
in a charitable point of view as of more value than an hundred-fold of 
the same value bestowed in money ; that in case of leaving my family 
for any considerable season, I should do it with an easier mind if satis- 
fied that they would on any and all occasions — of accident or disease — 
resort to the foregoing prescription for cure, than I should were they left 
in a position to command the best medical advice (apart therefrom) in 
the world ; and this assurance has been derived from a long and varied 
experience, that has fully satisfied me that there is no necessity that one 
life should be lost in New England, where there is now ten by what is 
called Typhus or Typhoid Fever — which, in fact, as a general rule, is but 
the ebbing away with a slow fever of the life from the blood in conse- 
quence of the impurities it is forced to consort with, first engendered by 
breathing foul air, gluttonous and hasty feeding, and other causes and 



THE DOCTRINE OF PURGATION. 181 

exposures, and subsequently aggravated by the malpractices of physi- 
cians — among the most prominent of which was the former practice of 
bleeding and parching to death with thirst, which practices were only 
abandoned by the faculty in consequence of an outside popular pressure, 
since which morphines and other narcotics have been substituted for the 
lancet with almost equal fatal effect, and which will be doubtlessly per- 
severed in so long as ignorant patients measure the doctor's skill by his 
ability to relieve effects at the expense of aggravating the disease, instead 
of working them off by removing their cause. 



APPENDIX. 



CURES BY PURGATION 



Cure of Abram Van Wart, of Sing Sing, of Bright's Disease of the 

Kidneys. 

Sing Sing, Oct. 14th, 1863. 
Dr. Brandreth, 

My Dear Sir: I was taken sick two years ago with a most severe 
pain in my right arm and elbow. Dr. A. K. Hoffman, of this place, pronounced 
it neuralgia. He treated me for some time, but getting no better, advised 
electricity ; I consented, but the shock nearly killed me, and I received no ben- 
efit whatever. After this my legs became numb and paralyzed, and my back 
and kidneys were tormented with most intense and continued pain. Dr. A. K. 
Hoffman and other physicians told me I had Bright's Disease of the Kidneys. 
They treated me for a long time, but finally pronounced my case hopeless. 
Other eminent physicians then treated me but did me no good, and gave my 
friends to understand that my case was incurable. So, at length, I gave up all 
hope, the lower half of my body being totally paralyzed and much swollen ; 
and I suffered terrible pain in the upper part of my body. My bowels were 
completely constipated from the paralysis, and no medicine produced a passage, 
and my urine was full of albumen. This was my condition five months ago, 
when my wife's sister, Sally Ann Storms, begged me to take Brandreth's 
Pills, as she had used them herself and in her family for many years with the 
best effect. Induced by her and my wife, I swallowed nine Brandreth's Pills. 
They operated twelve hours afterward, slightly. I continued taking nine every 
day for several weeks, their operation constantly improving. Finding myself 
a great deal better, I diminished the dose one pill a day, until I got to five. 
One afternoon, at 3 o'clock, about three months ago, I took five pills ; at 9 they 
commenced operating vigorously ; suddenly I felt as if something gave way 
inside, and the stools were like egg and water mixed, several quarts of which 
came away, of a most disagreeable odor. The next day I felt very faint, and 
my neighbors came to see me die ; but as soon as the faintness passed I was 
much better, and, for the first time in nearly two years, I was able to move and 
stand upon my legs. I continued taking the pills, and, in a very few days, was 
able to walk across my room, and now am able to walk quite a distance. I 
have taken altogether nineteen boxes of Brandreth's Pills, and now one pill a 
day is all I require. My health is nearly restored, my appetite is good, and I 
suffer hardly any pain anywhere, and every day I grow stronger. My neigh- 
bors look upon me as one risen almost from the dead, and I desire you to pub- 
lish my case, that those suffering from paralysis and kidney diseases may know 
how easily they may be cured by Brandreth's Pills. 

ABRAM VAN WART. 



184 CURES BY PURGATION. 



We, neighbors and relatives, certify that the foregoing statement of Abram 
Van Wart is true. 

A. B. REYNOLDS, Supervisor of the Town of Ossining. 

DAVID McCORD, Ex-Loan Commissioner. 

J. MALCOLM SMITH, Justice and Clerk Board of Supervisors. 

ABRAM HYATT, United States Assessor, Tenth District. 

JAMES McCORD, Loan Commissioner. 
RACHEL CYPHER, RACHEL ANN SLATER, 

WILBUR F. FOSHAY, LETITIA VAN WART, 

SARAH A. CYPHER, WM. SNIFFIN. 

The Methodist Society have heard the above facts stated in meeting from 
the mouth of Mr. Van Wart. 

Mr. John Archer, Ticket Agent at the Hudson River Railroad Station at 
Sing Sing, permits reference, he being fully acquainted with Mr. Van Wart and 
all particulars. 



In Epilepsy Brandreth's Pills Seldom Fail 

to cure, because they purify the blood. If we are sick from any cause we owe 
it to ourselves to use this remedy which Providence places within the reach of 
all. 

New York, July 8, 1861. 
Dr. Brandreth, 

Sir : A boy of mine was subject to fits from his infancy — his case was con- 
sidered hopeless by the doctors, who thought he would be subject to them for 
life. After they had given him up, I was recommended to try your Pills, and 
without much faith did try them, using them according to your printed direc- 
tions. Four years ago I commenced giving them to him, and to my great joy 
and relief he has had but one return only of his affliction since. I consider 
him now perfectly cured. 

The extraordinary benefit they did him makes me always recommend them 
to my friends, and I would be glad if everybody knew their value. The cause 
was the worst possible ; he would have been helpless and almost uselessly unfit 
for any kind of business from the length and severity of each attack — often 
lasting a whole night, and leaving him, for two or three days afterwards, en- 
tirely prostrate from weakness. Every kind of treatment was also externally 
applied that was professionally advised. You may, therefore, judge what good 
reason I have for letting you have this statement in . acknowledgment for the 
benefit received, and for the purpose of letting those who may be hesitating 
under similar circumstances have my testimony in confirmation of the relia- 
bility of the other certificates, and perfect confidence like myself in the value of 
the Pills. 

Yours respectfully, 

JOHN WEBB, 

18 Beehman Street. 



CURES BY PURGATION. 185 

Letter from General Paez, the Washington of Venezuela, / 

in favor of Brandreth's Pills. 

New York, May 30, 1865. 
Hon. B. Brandreth, 

My Dear Sir : I have received the supply of your invaluable Pills which 
you have so kindly sent me. I have not only used them myself in South 
America, as well as in this country, for the last thirty years, never allowing 
myself to be without them, but have purchased them by the gross to distribute 
to persons upon my estates and elsewhere, having found them efficacious in 
almost every variety of disease, especially those peculiar to the Southern con- 
tinent. I esteem, therefore, very highly the supply you now send me, and 
thank you very cordially for the kind words in which you convey your generous 
and friendly sentiments. 

I am, very respectfully, your obedient servant, 

JOSE A. PAEZ. 



Debility and Costiveness Cured. 

This certifies that I ha've used Benjamin Brandreth's Vegetable Universal 
Pills more than three years, and I do affirm that having used a great deal of 
medicine of various kinds I have found none so beneficial to my health as the 
above-mentioned pills. 

I have been unhealthy from a child, and have had the advice and attention 
of the most eminent physicians, who did for awhile alleviate my sufferings, but 
at last their skill proved unsuccessful, and I was sinking into rapid decay, given 
up by my physicians, and bending over the tomb without a jot of a prospect 
for recovering. While in that condition a friend recommended Brandreth's 
Pills to me. I sent immediately and got a box, and the first dose gave me so 
much relief that I repeated it, and after several doses, finding my health im- 
proving, I continued to take them two or three times a week for twelve months. 
At the expiration of six months I thought that my health was perfectly restored, 
but still my bowels were irregular and dormant, so I continued to take them as 
before, until the expiration of six months more, when I found, by gradually 
quitting, I did not need them more than once a month ; and since I betook my- 
self to the use of Dr. Brandreth's Pills, I have had no need of a physician, 
except in two cases, both of which needed skill more than medicine. 

During the first year after I commenced using these Pills I was very cau- 
tious both in the quality and quantity of my diet, but since that time I have 
generally eaten what was set before me. The Pills are the mildest in their 
operation of any medicine that I have ever taken ; they also produce the most 
powerful and free discharges of any medicine that I have ever used. And I 
speak from experience, that continued Use will not render them ineffectual in 
their operation. If I take a dose and they do not operate, I continue to take 
them, increasing the number of Pills in each dose, until powerful discharges 
ensue without any pain, and in a few hours I feel perfectly well and able to 
attend to business. 

Having derived so much benefit from the use of Brandreth's Pills, I would 
recommend them to all who are sick, whatever may be their diseases or com- 
plaint ; for it is manifest that nothing is more important- in any case of 
illness than to keep the bowels regular, and it is also evident, in my own opin- 
ion, that no better medicine than Brandreth's Pills can be obtained to keep the 
system in a healthy condition. 

R. DUNN, 
No. 22 Third Street, Cincinnati. 

June 1, 1860, 



186 CURES BY PURGATION. 

Remittent Fever, of the Island of St. Thomas, Cured by Bran- 

dreth's Pill?. 

New York, May 31, 1856. 
Dr. Benjamin Brandreth, 

Dear Sir : It seems to me to be a duty to say that, when I was United 
States Consul at St. Thomas, in 1849, I used your Pills with very great advan- 
tage. I was taken with the fever peculiar to that island ; the doctor bled me, 
and I was in very great danger of dying from that fever and the depleting. 
The inward fever was so great that no quantity of drinks seemed to relieve it. 
I was considered in very great danger, and I felt that my hold of life was really 
very feeble. In this condition I was recommended to use your pills. I at once 
took eight. Their effect was surprising. They seemed to be actuated by intel- 
ligence. I could feel them searching all round my stomach, even up to my 
throat ; every recess of the body was aroused to action. I continued to use 
them daily until I had taken two boxes, containing; twenty-five pills each, when 
I was quite recovered to my usual health. 

Governor Oxholm expressed to me the opinion that the Brandreth Pills 
were the best medicine he had ever known ; that he entirely relied upon them 
when he or his family were sick. He would not be* without them for any 
money ; that he believed you had been the means, by introducing them, of 
saving many valuable lives — a sentiment in which I concur most cordially. I 
desire, my dear Doctor, if you deem the above of any service, you will not be 
aTraid to publish it. 

I am, very truly, your friend, 

CHARLES H. DELAVAN, 
Late United States Consul for the Island of St. Thomas, West Indies. 



Cure of Dyspepsia of Ten Years' Standing by Brandreth's Pills. 

Bushwick, Kings Co., L. I., March 1, 1843. 
This is to certify that I was taken ill during the season of the cholera, in 
the year 1832, and continued ailing until the spring of 1842, during which time 
I was severely troubled with dyspepsia, and all its various train of suffering. 
I became extremely emaciated, melancholy, and worn out with suffering, so 
that life itself seemed burdensome. I, in the meantime, applied to a number 
of the best physicians, who prescribed for me ; and many were the bitter doses 
of medicine that I took, but without avail. At last I yielded to despair. The 
idea of taking the prescriptions of physicians any longer was useless, and I was 
bitterly opposed to taking pills. My friends became alarmed ; often solicited 
me to try Brandreth's Pills, asserting that they had derived great benefits from 
their use. At last I was tempted to give them a trial, and it is but just to say 
that, after using them a short time, I began to recover, and soon was entirely 
restored to health : and I think it a duty I owe to the world, and to Doctor 
Brandreth, to make this public acknowledgment. 

N. BLISS. 

Mr. Bliss will be pleased to testify as to the merits of Brandreth's Pills, 
after an acquaintance with them of twenty-three years. 

July, 1866. B. B. 



CURES BY PURGATION. 187 

Cure of Consumption and Dyspepsia. 

"Hammonton, New Jersey, May 7th, 1866. 
" Dr. Brandreth, 

" Dear Sir : I have long wanted to write to you and express my gratitude 
for the beneficial effects that have been experienced in my own family, and in 
hundreds, aye, thousands of others, by the use of Brandreth's Pills. The first 
year my lamented friend Brockway sold your pills in Boston (1838) I called at 
his office. I was then in a declining state of health, and my friends, as well as 
myself, supposed my earthly voyage would soon terminate. Mr. Brockway 
urged me to take the Brandreth Pills, but having used so much medicine, with 
no good effect, I was more inclined to let nature take its course, and calmly 
submit to my fate. Mr. B. offered to give me one dozen boxes if I would try 
them as prescribed. By this I saw he had great faith in them, and I finally 
consented to take them, but not as a gift. I went home and went at it, almost 
hopelessly. After taking one box 1 began to feel better. Well, sir, when I 
had used up my twelve boxes, I was apparently a well, healthy man, my weight 
having gone from 131 pounds up to 152 pounds. I then ordered a supply, and 
between that time and the present I have retailed three thousand dollars worth 
of these invaluable pills, and am quite sure that I have thereby been instru- 
mental in saving, not hundreds, but thousands of lives. I have given them to 
my oxen, horses, pigs, fowls, cats, dogs, and always with the desired effect. I 
have a wife and nine children, most of them born since I have used the pills. 
A more healthy family cannot be found. We are frequently asked how it is 
our children look so healthy. My wife replies that ' We raise them on Brand- 
reth's Pills.' Now, my children overload their stomachs, get cold and out of 
order, like others, but they have been taught the remedy, and go and take the 
pills of their own accord. This I consider an important branch of their educa- 
tion, and feel assured, as they shove off upon the voyage of life, that they 
know how to take care of themselves. I was in trade at my last residence, 
North Lincoln, Me., for 29 years. I have been here about seven years ; I am, 
therefore, well known, and my statements can be verified by hundreds. 

" Yours. 

"C. J. FAY, P. M." 



Certificate of Twenty-eight Years' Use. 

Newcastle, Westchester Co., N. Y., Aug. 11, 1861. 
Dr. B. Brandreth, 

My Dear Sir : I am now seventy-nine years old, and for the last twenty- 
eight years have been a constant user of your Vegetable Universal Pills when 
sick, fully realizing the advantage of enforcing purgation with a medicine, 
which, while harmless in its nature, removes all impurities. I can safely say 
that the vigorous old age I now enjoy has been caused mainly by the timely 
use of Brandreth's Pills. I have had, in these last twenty-eight years, several 
fits of sickness, and occasionally some infirmity of age would press upon me. 
At these times I have always found your Pills a sure remedy, giving me not 
only health but strength. I consider them, therefore, invaluable as a tonic, 
with qualities possessed by no other medicine known to me. I have never, 
during these last twenty-eight years, used any other medicine whatever, being 
convinced, by experience, that none was as good. Brandreth's Pills have also 
been freely used by my neighbors in every kind of sickness, and have never 
been known to fail when promptly administered. 

Yours truly, 

NATHANIEL HYATT, 
Justice of the Peace for Forty Years in Westchester County, N. Y. 



188 CURES BY PURGATION, 

A Man Saves His Leg. 

Sing Sing, Westchester Co., N. Y., Aug. 24, 1860. 
Dr. B. Brandreth, 

Dear Sir : Some years since a bad swelling appeared on my knee, and sev- 
eral physicians attended me. I kept growing worse and worse, until I was 
confined to my bed, a helpless cripple. Large quantities of matter kept 
coming from my leg, from six deep holes, together with pieces of bone. I lay 
in bed over one year, when the doctor came to me and said I had a very bad 
white swelling, and that the leg must be cut off or I would die. They wanted 
to cut it off then, and had brought all their instruments. I said, " No ; I 
would die first." So they left me. Despairing of cure, I took your pills. I 
began with four a day, and took them every day for a month, when my knee 
appeared a little better. This encouraged me, and though still in bed, I con- 
tinued taking your pills for four months more. I was now able to get up and 
go about a little with a crutch. I used the pills for three months more, when 
the sores all healed, and pain ceased, and I was well. I threw away my crutch, 
and now for the last four years I have been a well and healthy man, my leg 
being strong and my body sound. Words fail to express my gratitude to 
you. 

Yours truly, 

RICHARD T. BAKER. 
Westchester County, ss. : 

Richard T. Baker, being duly sworn, says, that the foregoing statement of 
his cure by Brandreth's Pills is true in every particular. 

RICHARD T. BAKER. 
Sworn before me, this 24th ) 
day of August, 1800. J 

A. Jackson Hyatt, 

Justice of the Peace, 



Dyspepsia Cured. 

"Bennington, Vt., Dec. 5th, 1843. 

" Dear Sir : I wish you to add my testimony to the host of others that 
you have in favor of your valuable pills. In the year 1838, I was attacked 
with that disagreeable complaint, the dyspepsia, which so affected me that I 
could not take the least particle of food without the most unpleasant and un- 
comfortable sensations in my chest, head, and bowels. My chest was so sore 
that I could not bear the slightest pressure without giving me pain. My health 
was most miserable ; many physicians told me they thought I was in the con- 
sumption, and that if I did not give up my business, and change climate, I 
could live but a short time. 

" I tried everything in the shape of medicine, and consulted the most skilL 
ful physicians, but found no permanent relief. I became, discouraged, gloomy, 
sad, and sick of life ; and probably, ere this, should have been in my grave, 
had I not fell in with your precious medicine. A friend of mine, who had been 
sick of the same complaint, advised me to try your pills : but, having tried 
most other medicines without obtaining any relief, I had but little faith that 
your pills would be of benefit to me ; but at his earnest solicitation, I pro- 
cured a box and commenced taking them. 

" The first box produced little or no effect, and I began to despond, for fear 



CURES BY PURGATION. 189 

that your medicine would prove like others that I had taken ; but my friends 
urged that one was not a fair trial, and I purchased a second, and before I had 
taken the whole box I began to experience a change ; the pain in my chest began 
to be less painful, and my food did not distress me as much as formerly. I 
went on taking them until I had taken six boxes, and my Dyspepsia was gone, 
and my expectation of an early death vanished, and I felt like a ' new 
creature.' I was then, .and am now, a healthy man ; I have never since been 
troubled with Dyspepsia. I have administered your pills to the members of 
my family, and to my friends, and in all cases with good success. You can 
publish this if it will be of any use to you. 

" I am, dear sir, truly yours, 

"J. L. COOK, 
" Publisher of the State Banner" 



Remarkable Case in which Fifty-two Pills were Used before the 
Bowels were Opened. 

John Pickett, living at 553 First Avenue, New York, aged 27, of robust 
constitution, from a severe wrench was Jaid up. His back pained him as if the 
muscles were torn. His bowels, kidneys, and bladder seemed paralyzed. For 
seven days nothing passed his bowels, spite of all the remedies administered 
by his three doctors, who told his wife they could do no more, and he would 
die. She was advised, as a last effort to save him, to give him Brandreth's 
Pills. So she procured a box, and gave him four pills every four hours. She 
rubbed the pills down to powder under a knife on a plate, and then mixed with 
molasses. - She continued this treatment until she had administered fifty-two 
pills, when they operated, and the man's life was saved. 

Observation Particular in respect to above Case. 

It is right here to call attention to the fact that while, in the first instance, 
this great quantity of Brandreth's Pills were required to produce a thorough 
cleansing of this man's 

PARALYZED BOWELS, 

two pills every day thereafter were all-sufficient to keep them open until his 
health was established. 

Thus we see how important a medicine Brandreth's Pills are ; suitable for 
the most trying emergencies of bodily affliction, as for the most simple disorder. 
Always safe yet always sure. 

They are indeed a century in advance of all other purgatives. 



Fever and Ague Cured. 

Mr. John Y. Ilaight. Supervisor of New Castle, Westchester County, New 
York, desires the attention of those interested. He says : " I was, about two 
- ago, attacked with fever and ague, which, notwithstanding the best medi- 
cal advice, continued to sorely affliet me for six tedious months; I became yel- 
low as saffron, and reduced to skin and bone. Medicine and physicians were 



190 CURES BY PURGATION. 

abandoned in despair. As an experiment, I concluded to try a single dose of 
six of Brandreth's Universal Vegetable Pills on an empty stomach, early in the 
morning. The first dose seemed to arouse all the latent energies of my ex- 
hausted frame. Their purgative effect was different from anything I had ever 
used or heard of. At length this effect ceased, and I seemed lighter and 
breathed freer. That evening I was indeed sensibly better and slept soundly 
all night. The next day I followed the same course and took the same number 
of pills. I continued to take the pills in this way about three weeks, when J 
found myself entirely cured. It was two years ago, and I have had no return. 
My health has been surprisingly good, and I have used no medicine since. 



Mr. Carpenter, of Gouverneur, New York, sixty-four years of age, says 
he has used Brandreth's pills for thirty-four years ; administered them first to 
his coachman, who had Fever and Ague ; gave eight the day after the chill ; 
chill and fever less severe ; gave eight more the next day, and so every other 
day, until the chill and fever did not return, which was in about eight days 
from the first attack. He then gave four every other day another week, when 
the man was entirely restored to his usual good health. 

He was himself attacked, took them in the same way, and was cured in less 
time ; has used no other medicine for thirty-four years ; found them always 
every way reliable for himself and for his family when sick ; has recommended 
them to thousands with the best results ; feels confident that every family 
would have a larger average of health if these pills were used in the place of 
calomel and other hurtful remedies. 



The following is an extract of a letter from Hon. Caleb Lyon, of Lyons- 
dale, now Governor Lyon of Idaho, to Dr. Brandreth : 

" My sincere thanks are due you for the boxes of Brandreth's Pills that you 
were so kind as to send me previous to my departure for the East; and a more 
efficient medicine as a preventive of disease upon the miasmatic shores of the 
Danube, or the plague-stricken cities of Egypt and Asia Minor, I do not believe 
was ever used. My whole party took them freely, and while others were ill 
and delayed, we kept well. Enclosed you will find the translation of a letter 
from Achmet Hallilla, an Arab Sheik, to whom I presented several boxes. 

" ' Peace be unto you and length of days ; thy medicine (Brandreth's Pills) 
was a fierce foe to Azrael, both in pestilence and caravan sickness ; the little 
orbs were rich with the wine of health ; let the maker wear this golden circle, 
that he may know I was wounded with the arrows of disease, but am now 
healed. 

" : May he grow in the sunshine, and dispensing blessings be the most blest. 
(Signed) " < ACHMET HALLILLA.' " , 

Brandreth's Pills are both sugar-coated and plain. 



Paralysis of the Legs, of Seventeen Years' Duration, Cured by 
Brandreth's Pills Alone. 

Extract of Consul Graham's Letter to Dr. JBrandreth, on file at 294 Canal 

Street. 

General T. has a brother over forty years of age, whose legs have been 
paralyzed for seventeen years, so that he could not walk a step. He has tried 
all sorts of remedies, and been under the care of various physicians, all of 



CURES BY PURGATION. 191 

whom have pronounced his case incurable. I gave my friend a box of Bran- 
dreth's Vegetable Universal Pills, with the printed instructions ;' his brother 
took them, and was so pleased with the effect that he prevailed upon Messrs. 
Zimmerman & Frazer to let him have a few dozen boxes. He has now taken 
some thirty or forty boxes, and is so far recovered that he can walk with a 
cane, and has full faith that he will recover entirely. He is so enthusiastic in 
favor of the pills, that he has cut your likeness from some of the package-labels 
and has posted it over his tablg, and frequently burns a candle before it (he is 
a Catholic) ; and when his friends come in he points to it, saying that this is 
the true "saint," "my saint; all the rest I value nothing in comparison." 
This gentleman entirely recovered the use of his limbs, and is now one of the 
healthiest and soundest men in Buenos Ayres. 



Captain Berry, formerly of the New York Custom House, had also lost the 
use of his legs, and was obliged to use crutches. He resorted to Brandreth's 
Pills ; three months' vigorous use cured him of his rheumatism entirely. 



Cancer Cured. 

Mary H., wife of L. D. Grosvenor, of the United Society, Harvard, 
Mass., was cured of a cancer of many years' standing. " The prospect of ter- 
minating my life by the ravages of that insufferable scourge of humanity, the 
cancerous tumor, was certainly prevented by the timely and persevering use of 
Dr. Brandreth's Medicine, and a wonderful cure effected." 



Isaac "W. Briggs, of 145 Suffolk Street, New York, says he has used Bran- 
dreth's Pills for thirty years, having commenced to use them in February, 
1836, for dyspepsia and affection of the kidneys. He took Brandreth's Pills 
every day for thirteen months, and in March, 1837, became a perfectly sound, 
healthy man. Mr. Briggs will be pleased to answer any questions on this 
subject. 

July, 1866. 



United States Sanitary Commission, ) 

Wethersfield, Wyoming County, N. Y., June 27, 1865. j 
Doctor Brandreth : — This certifies that I have used your celebrated Pills 
for over twenty years, personally and in my family. When we are sick, in- 
stead of sending for a doctor, we use Brandreth's Pills. I believe if every one 
would adopt the same course, the doctors would have but little to do. I have 
traveled in fifteen States, and been in the army sixteen months, and necessarily 
exposed to much disease, yet by the use of your Pills occasionally, have secured 
my health through the biting winter's frost and the scorching summer's heat. 



192 CURES BY PURGATION. 

In fact, Doctor, I feel, with your Pills in my pocket, safe from the attacks of 
disease. They seem to cleanse the blood and regulate the system, whether it 
be troubled with dizziness, diarrhoea, or costiveness. When out of sorts, I use 
them, and they always cure me. I would not be without them for four times 
their cost. 

I send this to you that others who know me may profit by it, wishing to do 
good to my fellow-beings. 

N. HIGLEY. 



Dyspepsia and Costiveness Cured. 

D. J. TENNY'S CASE.-^iV^ York Mentor, January 14, I860.— 
Whether the Brandreth's Pill is ever convertible into blood we will not now 
discuss. But our chief object at this time is to give a statement of a gentleman 
who says he has taken one of the Brandreth Pills for at least sixteen months, 
daily, or about 480 days in succession, and who says that at the end of that 
time he considered himself cured of Dyspepsia, attended by a constant costive 
state of the bowels, which had troubled him for a long time. 

This gentleman, Mr. Daniel Tenny, resides at the Astor House, in this city, 
and has been in the enjoyment of excellent health ever since he was cured by 
this treatment. He is an intelligent man, and there is no doubt of the truth of 
his statement. This proves, at least, that as many as one of the Pills prepared 
by Dr. Brandreth can be taken for nearly 500 days in succession without harm, 
and at the end of that time a dyspeptic and costive habit of body may be per- 
fectly cured. This could not be said of any of the cathartics in use by those 
who style themselves the Regular Faculty. 



Asthma Cured by Dr. Brandreth's Pills. 

The following cure of Asthma by the use of Dr. Benjamin Brandreth's 
Pills is authenticated by seventeen well-known respectable citizens of Green- 
wich, Conn. : 

This will certify that Thomas S. Brown, who had been for some time pre- 
vious much affected with asthmatical symptoms, was taken suddenly worse on 
the 12th of June last : he began to cough and raise phlegm, and in the course 
of twenty-four hours expectorated nearly two quarts of thick white jelly-looking 
matter. Three physicians pronounced it a nervous humid spasmodic Asthma, 
and after prescribing for some time, to no effect, the three consulted together, 
and finally declared that they could do him no good ; it would and must result 
in consumption, and death would ensue, and that in a very short time. The 
pain was excessive in all parts of his body; and the difficulty of breathing was 
such as almost to cause strangulation. He was reduced to a mere skeleton, 
and finally gave himself up to death. After being in this miserable state nearly 
two months, he saw an advertisement of Dr. Brandreth's Vegetable Universal 
Pills, and immediately sent by Captain J. Waring, of Greenwich, for a 25-eent 
box, and found relief in the course of a few days. It is proper to say that he 
commenced with two pills at night, and two in the morning ; he found relief the 
second day, and encouraged thus to persevere with larger doses, he was soon 
able to sleep comfortable, and now, having taken them for about four months, 
according to the directions, is entirely recovered, and so far as we can judge, 



CURES BY PURGATION. 193 



entirely in consequence of taking the above Pills, which we have also used in 
our families, and have found them invaluable. 

James R. Mean, James Moore, 

Daniel S. Betts, Hannah Hitchcock. 

John H. Reynolds, James Mead, 

Abel Palmer, Thomas Bertram, 

Rev. R. Palmer, Isaac Olmsted, 

John R. Palmer, P. V. T. Jessup, 

Henry Bewslev, Stephen Waring, 

Samuel Jessup, Augustus Lyon, 

John Limpry. 
Mrs. Mary Blanchard, 206 Clermont Avenue, Brooklyn, was cured of 
Asthma of long standing by 

BRANDRETH'S PILLS. 
She is acquainted with other cases of persons cured of Asthma by the same 
remedy, and kindly permits reference. 



Painters' Colic Cured. 

Dr. Brandreth, 

Sir: — I am a painter by trade, and have frequently been troubled with 
slight attacks of colic, arising from contact with lead in the forms it is used in 
my business. My eyes have also been made somewhat weak from the same 
cause. Your pills have been my only medicine, and they have never failed to 
restore my health. For all the diseases incident to a painter, I think Bran- 
dreth's Pills a certain remedy. My journeymen, by my advice, always take 
them whenever their arms become paralyzed, or their bowels constipated, and 
they have been cured by a few doses. Painters will find your pills invaluable. 

Yours, &c, DENNIS NORTON. 

Sing Sing, March 23, 1865. 



Saint Vitus' Dance Cured, of Twenty-five Years' Standing, with Brand- 
reth's Vegetable Universal Pills. 

Sir : With the most grateful feelings and the highest consideration for you, 
I sit down to state one of the most remarkable cures perhaps you have ever 
received, and effected, sir, entirely with your never-to-be sufficiently praised 
Vegetable Universal, and, I might add, life-restoring Pills. 

The gratitude I feel makes me scarcely able to state the case, which would 
not, I am sure, be believed, were it not universally known in the town of Ware- 
ham, where we reside, and the miserable condition my dear wife, Lucy Hooker, 
has been in for the last twenty-five years, now restored to health and to her 
family, when for so many years she was considered to be beyond all human 
aid. 

For the last twenty-five years my wife has suffered from Saint Vitus' Dance, 
and a complication of diseases which the doctors only seemed to continue to 
make worse instead of better. Calomel and bleeding, tonics and blisters, then 
calomel and bleeding, tonics and blisters again. Every doctor round the coun- 
try at all famed was tried, until finally, she receiving no benefit, I thought I 
would try the mineral doctors no more, and therefore took her to Boston to 
Dr. Thomson. She went through several courses of his treatment, and ap- 
peared to gain some thereby. But alas ! she soon became as sick as ever. I 

13 



194 CURES BY PURGATION. 

then was obliged, she becoming suddenly worse, to send for two of the Ware- 
ham doctors again. They told me candidly she was beyond the powers of 
medicine, and that she must soon sink under her diseases. What was I to do ? 
I had often been recommended your pills, but always held them in contempt. 
One medicine and one disease I could not understand. I told your agent, 
Abishia Barrows, of Wareham, what the doctors said. Again he strongly 
recommended the pills. 1 talked to my wife about them ; she said she would 
try, if there was any hope — hoped they might be blessed to her, but that she 
was resigned. I went for a box, and when I returned one of her doctors was in 
the room. He made a deal to do about it, said she could not bear them, they 
were too strong for her, she could not bear any kind of physic, that she would 
die in all probability from the effects of the first dose. The more he said in 
opposition the. more Lucy was determined to try them, and actually took a dose 
of four pills in his presence, and while he was holding forth against them. Away 
went the doctor and reported through the town that J was killing my wife by 
giving her those Brandreth's Pills — those Prince of Quack's Pills — those Im- 
postor's Pills — and created quite an excitement. In the meantime she was 
receiving the benefit. 

The first dose of four had a most wonderful effect — no wonder at the state 
she was in. The corruption was indeed dreadful. She took six the next night, 
and the same results. Instead of their causing weakness, she became stronger, 
and able to sit up a little. She persevered, sometimes taking as many as twelve 
at night and 'seven in the morning. When her pains were severe she took 
larger doses, and she did the same if the appearance of the evacuations was bad 
• — in fact we followed your printed directions most carefully. 

Sometimes she became worse — all the worst symptoms of the disorder pre- 
sented themselves. Often at such times have I trembled lest she should die ; 
but by persevering with the pills she soon recovered ; and after every attack of 
this kind she seemed to be more firmly established in the recovery of her 
health, or rather her health seemed stronger after each of these attacks. At 
first, not only the doctors opposed her using the pills, but all her friends and 
relations ; they all considered that the pills would surely accelerate her death. 
But long since the tide of opinion has changed, and those who most opposed 
now most strongly recommend them. 

It is about sixteen months since she took the first dose. She has used in all 
one hundred and fifty-two boxes, all purchased of your agent in this place, Abi- 
shia Barrows. I consider that she is like one raised from the grave, to bless 
myself and family, and give your pills and a kind Providence all the praise. 
She has not enjoyed so good a state of health since she was a child, certainly 
not since we were married. 

The doctor w T ho saw her take the first dose, I understand is entirely con- 
verted to your principles of curing diseases by continued purgation, and is try- 
ing to find out what your pills are made of. But I believe he uses your pills 
in his practice — in fact I feel sure of it. 

The cures which have been made in our region since my wife's recovery are 
truly surprising. Every one that feels sick thinks of no other medicine than 
Dr. Brandreth's Pills. I hope, sir, you will come and favor our town by a 
visit ; you will find many grateful hearts to welcome you. 

In the hope that you will live long to benefit mankind, I and my wife join in 
our mutual kind wishes and grateful feelings, and remain, 

Very respectfully, 

WILLIAM HOOKER, 
LUCY HOOKER. 

Wareham, Barnstable Co., Mass., May 23, 1838. 



CURES BY PURGATION. 195 

Yellow Fever Cured. 

A gentleman, with whom I am well acquainted, writes as follows : " In 
1S88, at New Orleans, at the St. Charles Hotel, while at table taking dinner, 
before the soup was removed, I was taken with dizziness, dimness of sight, and 
confusion of ideas ; in short, all the symptoms of yellow fever, though well five 
minutes before. I asked a waiter to lead me up to my room, for the confusion 
of mind and dizziness was so great, that I could never have found the way 
alone. When there, I took eight Brandreth's Vegetable Universal Pills, and 
laid down. I was watched carefully, and for three or four hours was partly 
delirious ; but in four hours the pills began to work, and my mind was clear 
enough to know my danger. Bleeding was recommended. ' Do you think,' 
said I to the doctor, ' I want depleting V ' Your life is not safe without it,' was 
the reply. ' Then I will take eight more Brandreth's Pills,' said I. Those on 
the top of the first eight, with plenty of Indian meal gruel, carried me out of 
all danger, and half a dozen medium doses cured me entirely in less than a 
week. Those who want to be safe, should take a few doses of pills as a pre- 
ventive." 



Tenea, or Tapeworms, Entirely Eradicated with Brandreth's Pills. 

Reading, Fairfield County, Conn. 
Dr. Benjamin Brandreth : 

Dear Sir — I have been troubled with the tape worms for twelve years; 
many have come from me, from twenty to thirty feet long — more or less every 
day of shorter ones — every two or three weeks I had a sick time from them — 
pressure at stomach — heavy load — many have crawled from me while at work 
— injured my health so much that I was not able to work one half the time — 
spent a great deal of time and money in consulting physicians and taking their 
prescriptions — have been reduced very low by taking medicine, without effect 
— last fall heard of Brandreth's Pills as a Cure All — had but little faith in them, 
but was determined to try any, everything, I could find at all probable to cure, 
thinking that without some remedy I must be destroyed by them. I procured 
one box, took one dose, and one worm came from me ten feet long ; took the 
second and third, which cleaned them all out, and I have not had one since. I 
have, however, taken several boxes of pills since, but have seen no appearance 
of worms. It is now ten months since, and I have gradually recovered my 
health, and am now able to attend to my business as usual, and have no doubt 
that they are all extinct. When I was afflicted with worms, I wanted to con- 
sume three times as much food as I would if in good health. Now I take my 
regular meals, and am hearty and enjoying good health, and able to do a good 
day's work. The last worm that came from me was twelve feet long. I have 
not the least doubt that it was Brandreth's Pills (your valuable Vegetable Med- 
icine) that effected the cure, as everything else that I could hear of was tried 
without effect. 

Yours very respectfully, and grateful servant, 

AARON T. DIMON. 

June 20, 1838. 

The above person is well known in Fairfield County. John B. Sanford, of 
Bridgeport, Conn., has assured me of his respectability. 



196 CURES BY PURGATION. 



Cure of Pimples on the Face of Three Years' Continuance. 

Dr. Brandreth : 

Dear Sir : For some considerable period I have been troubled with an 
impurity or acridity of the blood, which seemed to be past cure. My face, 
in consequence, presented an unseemly collection of pimples. I was abstemious, 
and seldom tasted any beverage stronger than water, and yet, with all my care 
as to diet, my blood got no better, and my appearance continued the same. My 
face all the time seemed as if it was held near a fire ; it seemed as if something 
was on it that might be brushed off. It was very annoying, and caused me 
much anxiety, not because it interfered with my personal appearance, which it 
did, but because it more or less affected my health, which was beginning to 
break down. I took very little medicine ; but when the above state of things 
had remained about the same for three years, I was induced to use your pills. 
I took them, in all, about one month — every day, or nearly so — taking no higher 
dose than five pills, and sometimes only one. I think, altogether, I did not use 
over four boxes. They cured me completely. My face is free from all pim- 
ples and inflammation, and my complexion perfectly clear. Gratitude has in- 
duced me to render this account, which you may publish. 
I am, with respect, yours, &c, 

N. H. BAKER. 

Sing Sing, March 30, 1855. 



The following modest note from Mr. Bemis, of Dudley, Mass., for a supply, 
tells its own story : 

Dudley, December 7, 1853. 
B. Brandreth : 

Dear Sir — I have sold all the Pills I had of yours, and the money is ready 
when you will send my receipt. Please to send more Pills as soon as you can 
— send to Webster Station. I have sold $117 worth of your Pills, and they 
give universal satisfaction. 

Yours, with respect, 

PIIINEAS BEMIS. 



Brandreth's Pills Never Failing in Diarrhoea and Dysentery. Read. 

Battery Anderson, Sept. 9, 18G4. 
Dr. Brandreth, New York : Please find one dollar enclosed, for which 
send me that worth of your Pills, as I have used and given all I had. These 
Pills have cured all who took them for the diarrhoea in a few days. Some had 
the disease two or three months. The army doctors had failed to cure in all 
of these cases. 

I have found your Pills to be never-failing in diarrhoea, bilious affections, 
headache, and costiveness. How is it the Sanitary people do not give out your 
Pills? 

Yours, with great respect, 

PAUL P. DUFOUP, 
Co. A, Thirteenth Heavy Artillery, Bermuda Hundred, Va. 



CURES BY PURGATION. 197 

Captain Isaac Smith, of Sing Sing, says, thirty of Brandreth's Pills, taken 
according to directions, cured him of a very severe bronchial affection, after 
other means had failed, and he wishes his numerous friends to know the fact. 



Extract from a letter dated Dawson, Iowa, April 24, 1866, to Dr. Brand- 
reth, from Andrew Logan, Esq. : 

" My wife became an invalid. Our physician represented her case as in- 
curable. I then called two other physicians, and the three held a consultation 
and pronounced her case consumption. I then discharged all the physicians 
and determined to trust to your Pills. I got five boxes, which she took accord- 
ing to the printed directions. By the time these were used up, there appeared 
a change in her condition for the better. I then bought fifteen boxes, and she 
continued to take them for three months, when her health was entirely re- 
stored." 

Original letter at 294 Canal Street. 



Persevere in the Good Work. 

The Rev. Ezra Wilmarth, East Wilson, N. H., says : " He has seen the 
salutary effects of Brandreth's Pills in many cases, and is fully convinced of 
their great value ;" that he " thinks it his duty to recommend them wherever 
he knows there is sickness, and is confident that they are calculated to promote 
the general health of mankind." 



Nervous Debility and Bilious Headache. 

Mr. Webber, whose case is mentioned below, is still living, a fine healthy 
man of over 67 years : 

William Wood Webber, of Grigg Street, Southsea, in the Borough of 
Portsmouth, England, bell-hanger, voluntarily cometh before me and maketh 
oath and saith, that he was for five years and upward dreadfully afflicted with a 
nervous debility of his whole system, attended with a bilious headache which 
prevented him (deponent) from attending to his business the greater part of 
that time. He (deponent) has sometimes been so violently affected as to fall 
down senseless, which had nigh once put an end to his existence. In this mel- 
ancholy state he was recommended ' to take Brandreth's Vegetable Universal 
Pills, and after taking them for four or five weeks, according to the directions, 
he was perfectly cured. It is necessary and essential to observe that after 
taking them six or eight times he was much worse ; but Dr. Brandreth informed 
him that such would be the symptoms, and prevailed upon him (deponent) to 
persevere, which he did ; he therefore went on, as above stated, and the most 
beneficial results followed. It is now six months since deponent was quite 
cured, and he has had no return of the said disorder, but keeps in the enjoyment 
of perfect health, which he entirely attributes to Brandreth's Pills, the Vegeta- 
ble Universal Medicine. 

WILLIAM WOOD WEBBER. 
Sworn at Portsea, in the said borough, this 15th ) 
day of December, 1831, before me, j 

D. Spicer, Mayor, 



198 CURES BY PURGATION. 

Indigestion and Disordered Liver. 

Brandroth's Pills are warranted free from all mercury. or other mineral. 
A gentleman writes : 

" I have for years been afflicted with disordered liver- and indigestion, and 
have been restored after years of suffering, merely by the use of some fifteen 
boxes of the Brandreth Pills. For several years I have been more dead than 
alive ; I have crawled about, for my locomotion could not be dignified by say- 
ing I walked. I had the best advice, but was blistered, bled, took blue pill and 
calomel until my mouth was sore, dieted, and drank mineral waters. At last 
I saw hope wiped out of my doctor's and relatives' looks — it was clear I was 
doomed. In fact this was to be expected ; for when I did get up in the morn- 
ing, I was more dead than alive ; I was unable to attend to any business, and 
exertion of any kind seemed too much for me to endure. In this sad state I 
read J. W. Webber's case, and also Mr. Cooke's, of Bennington ; these letters, 
with the advice of a friend, induced me to give the Brandreth Pills a trial. I 
began with only two pills, which purged gently ; in a few days I took two 
more, they also operated mildly : then I took four, feeling some apprehension 
about my bowels ; they operated finely, bringing away very slimy stools. I 
rested for a day or two, and then took two more ; then I took six, and at last 
I became fully convinced of the efficacy of purgation, as a cure for disease. I 
have taken as high as eight pills in twelve hours — but the dose must be in pro- 
portion to the sickness — inflammatory cases require strong doses, and all 
serious sickness where pain is present, the same. But with weak persons the 
plan is to begin easily, and sort of feel your way, taking larger doses as you 
proceed. This method in the use of Brandrcth's Pills has cured me, and re- 
stored to health one who had prepared himself for the grave." 



Letter from Arnold Buffum, 

THE PHILANTHROPIST. 

Cincinnati, Ohio, April 15, 1843. 
Dr. Brandreth : 

In the course of my life I have suffered often and much from sickness ; I 
think I have been under the care of physicians more than twenty different times, 
for weeks at a time. But for the last five years I have employed a physician 
but once, and then only for a single day ; not, however, because I have been 
exempt from frequent illness, but because I have found a fir more speedy and 
effectual remedy in thy Pills, than I ever found in the medicines administered 
to me by my physicians. Wherever I go, I constantly carry a box of them with 
me, or at least a few of them wrapped in a paper in my vest pocket ; and 
whatever illness comes upon me, I invariably find relief from the use of 
them. 

Having been much occupied m travelling and public speaking, I have 
frequently taken severe cold, which before I used these pills, invariably resulted 
eness of the throat and chest, and a severe coueh : but latterly, though 



in sor 



, wiiu c* uv.wv v,v« & j 



more exposed than ever, when I have taken a cold, by taking one or two pills 
at a time for two or three nights, I have invariably succeeded in removing all 
soreness of the throat and chest, and in effectually preventing the cold from set- 
tling on my lungs so as to produce a cough. 

Once during last winter, while travelling on horseback, and subject to 
much exposure, I was suddenly seized with a very sore throat, high fever, and 
entire prostration of strength and spirits, — by the use of two doses of the pills, 



CURES BY PURGATION. 199 

and drinking freely of cold water, a copious perspiration was kept up, and in 
forty-two hours one of the most severe attacks which I ever experienced gave 
way ; and in two days more I was able to pursue my journey. At another 
time, continual exposure and daily exercise in public speaking brought on a 
severe lameness in the small of the back and kidneys, which became so 
exceedingly painful that I was forced to speak sitting ; not being able to stand 
on my feet ; at length the soreness extended quite through me, and the pain 
became so severe that I never closed my eyes during a whole night, and 
several times during that night I had serious doubts whether I would live till 
morning. I took seven pills, which went to the seat of the disease, and as by 
magic, seemed to lay hold of it, and carried it all off, so that I attended a 
meeting on the same evening, and spoke without pain for more than two 
hours, and the pain has not returned since. I regard this as one of the most 
extraordinary cures that I have ever known, and I can truly say that, in a 
similar case, I would not exchange Brandreth's Pills for all the medicine of 
the drug store. I have used the Pills, and administered them to others on 
various other occasions, and, as far as I know, in no case without complete 
success. Especially have I found them altogether superior to any other 
medicine I have ever tried for colds, coughs, and soreness of the lungs. I 
consider that the maker of them especially serves the great cause of humanity, 
and I shall recommend them wherever I go. 

Thine respectfully, 

A. BUFEUM. 



In October 1843, Aaron Hamilton of Sing Sing, Westchester county, was 
taken suddenly sick in the night with great pain in his bowels and stomach. 
He took six Brand reth Pills, and in two hours took four more. In a little 
time he threw up two worms, and passed several downwards. He has enjoyed 
good health since. 



Dear Sir : 



St. Vitus' Dance and Scrofula Cured. 

Sing Sing, 3d January, 1843. 



It is with gratitude and esteem that I address you for the purpose of in- 
forming you of the beneficial effects which your Pills and External Remedy have 
had in restoring one of my sons to health, who had been sorely afflicted 
winter before last with St. Vitus' Dance, and for a period of ten months he 
was entirely helpless from the terrible disorder. He was also subject to the 
Scrofula in his neck. By the use of your Pills freely, and also applying the 
the External Remedy to the enlargements upon his neck, he has become en- 
tirely cured. He has been now well over a year ; and I trust, by the blessing 
of Divine Providence, he will continue so. 

You are at perfect liberty to make what use you please with this commu- 
nication. I consider it a duty I owe to you to make it, and hope it may be the 
means of extending the usefulness of your most excellent medicines. 

I remain yours, respectfully, 

H. M. REQUA. 
To Dr. Benjamin Brandreth, 

Spring Hill, Sing Sing. 



200 CURES BY PURGATION. 

Indigestion and Bilious Affection Cured. 

Sing Sing-, January 14, 1843. 
Dear Sir : 

This will certify that I have used your Vegetable Universal Pills for in- 
digestion and bilious complaint which had almost proved fatal to me. I had 
been under what was supposed good medical treatment, and used various 
advertised remedies, but without any good effect. I then made trial of your 
celebrated pills, which gave me immediate relief, and soon effected a perfect 
cure. I have since used them in my family with the best effect. They are 
the best and easiest purgative we ever used. 

I am, respectfully, yours, 

NICHOLAS FOWLER. 
Dr. B. Brandreth, 

Spring Hill, Sing Sing. 



Sing Sing State Prison, Feb. 4, 1843. 
Dr. Brandreth, 

Dear Sir : About four years since, I had a very severe attack of the piles. 1 
tried almost every remedy, but without any good effect upon my painful disease. 
I thought I would try one box of your Vegetable Universal Pills. I done so ; 
and before I had taken all the pills it contained, I began to feel the good effects 
of them ; and by the time I had taken four boxes of pills, I was entirely cured, 
and have never since been troubled with the painful and truly unpleasant 
disease. I entirely attribute my cure to your valuable and inestimable 
pills. 

Very truly yours, 

R. LENT, 
Architect, Sing Sing State Prison. 



Sing Sing, Jan. 24th, 1843. 
Dr. B. Brandreth, 

Dear Sir : If you alone were concerned in the present statement, the greater 
inducement for making it would be removed, for of course no testimony can 
strengthen you in your convictions in relation to the value and efficiency of 
your Pills, which have already proved such a blessing to the thousands who 
have used them ; but I have looked out upon this vast expanse of creation, en- 
circling in its arms, as it does, thousands bowed down with sufferings similar 
to my own, who would gladly hasten to the same source that restored my 
health, if they were persuaded that they would meet with the same happy 
result. Therefore, Sir, it is that those thousands may be convinced, and profit 
by their conviction, as I have done, that induces me to state before the world 
a period of suffering, such as few have, and I hope few ever will know, and 
the permanent relief I received from your Pills ; but how to begin, I hardly 
know, to describe those extreme tortures that seized upon my arms, shoulders, 
side and face, having about ten years since contracted a very severe cold, 
causing a very severe fit of sickness, attended with an affection of the Liver, as 
was supposed, which was the consequence of my taking a great quantity of 
medicine — and I must say, I have not seen a well day since, until I commenced 
taking Brandreth's Pills. For the last ten years I have been afflicted with 



CURES BY PURGATION. 201 

what is commonly called Salt Rheum and Erysipelas, at times covering and 
seeming determined to devour my whole body, and by making use of various 
means was enabled to check the disease from time to time, until early in June, 
1841, my disease assumed a very different appearance; and unpleasant as the 
task now is to me, I will, for the sake of spreading light and knowledge in the 
world, give a few of the particulars of my case : swelling and painful affections 
of the joints, tumors formed under the skin with burning lacerating pains, and 
finally coming out in horrible sores, covering nearly the whole of the right 
arm, and penetrating almost to the bone, and spreading to my face, covering 
nearly half including the nose, making for the time an entire wreck of that 
organ ; from thence to my shoulder and side, and my whole body and limbs 
swollen in the most frightful manner. Residing at this time in one of the 
western cities of New York State, I had recourse to most of the eminent Phy- 
sicians of that part of the country ; and the most that they could do was to 
pronounce the disease a scrofulous affection, which it seems they were not pre- 
pared to combat. A change of air and climate was recommended, and in travel- 
ing I became acquainted with a lady from Sing Sing. She advised the use of 
Brandreth's Pills — but supposing that they could be of no use to me, as I had 
tried so many things, I thought little more of them at that time ; but after having 
endured the most excruciating tortures, and incurring great expense, I was, 
thank God, about six months since, by reading one of Dr. B.'s advertisements, 
and what I had heard about them, induced to purchase a box of Brandreth's 
Pills. Jealous of the article, I resolved not to have my imagination at all 
busy, but nevertheless to give them a fair trial, which I did, by taking accord- 
ing to the directions accompanying each box, as far as my feeble state would 
admit, two or three boxes. Overjoyed at the discovery of an article which I 
well knew improved my health, used them secretly for a few weeks, but be- 
coming convinced that Brandreth's Pills would cure me, I made bold to declare 
it. 

Sir, are you alone concerned to know it % I think not, for I know that the 
medicine that possesses the power to cure me is capable of conferring the same 
blessings upon thousands of others suffering, perhaps dying ; therefore, these 
are all concerned to know that they can be cured. In fact, all are concerned in 
the discovery of anything that tends to promote the happiness of the human 
race, for we are social beings and cannot suffer alone. Persons may doubt this 
statement as I have doubted similar ones, but be assured it is but too true ; 
and in giving it, I have unsolicited, to you, sir, and the world, if you choose to 
publish it, discharged a duty which I felt incumbent upon me in making it known 
for the benefit of those who choose to believe it, as I believe that I have been 
cured of a scrofulous affection of the worst possible character and of long stand- 
ing, by the use of less than twenty boxes of Brandreth's Universal Vegetable 
Pills, at an expense of less than Five Dollars, instead of chasing phantoms at a 
greater advance in fees, without any good results ; and when I look into the 
past, upon these solitary days and sleepless nights, I thank a kind Providence 
that it is as well with me as it i», and I thank you, sir, that you are enabled by 
your scientific researches to minister to our infirmities. 

RACHEL TURRELL. 



Fits Cured. 

This may certify that my son, of five years old, was attacked with epileptic 
fits, in 1837, and continued to be troubled with them for more than one year. 
After every other remedy ha'd failed I tried the Brandreth's Pills, which effected 
a cure in about six months, and he has not been troubled with -them since. 

DAVID CHAFFEE. 

Grafton Street, August 2, 1843. 



202 CURES BY PURGATION. 

Mr. Wilson, of 135 Christie Street, for twelve years was afflicted with 
Chronic Rheumatism, and for the last three years was not able to walk ; has 
taken twelve boxes, the pain has entirely left his feet and knees, so that he is 
able to walk with comfort. 



Miss W*****, a young lady residing in Hubert Street, had a severe pain in 
her knee, from which she suffered excruciating pains for upwards of three years, 
which confined her to bed almost all the time. Dr. Mott and several others of 
the faculty had bled, leeched, and blistered to no effect ; by taking Brand- 
reth's Pills she has perfectly recovered the use of her knee. Observations on 
the above would be superfluous. 



Mr. G. Miller, of Harlaem, in September last, was dreadfully afflicted with 
Fever and Ague ; the attack generally came on him every day about 12 o'clock ; 
the disease had debilitated him in such a manner that his recovery was doubt- 
ful. A gentleman who has tested the goodness of Brandreth's Pills, in his own 
family, persuaded him to try the medicine. After the first box the Fever was 
perfectly cured, and by continuing taking the medicine for about six weeks, per- 
fect health was restored. 



Benj. Weeks, of Westchester, was violently afflicted with Dyspepsia; he 
could not take any food without the most unpleasant sensations in his chest, 
head, and bowels. His chest was so sore that the slightest pressure gave him 
pain ; his life was most miserable ; numerous were the medicines used ; and the 
skill of the first physicians tried in vain ; as a last recourse he took Brandreth's 
Universals, and in two months they etfected a perfect cure. 



Worms. 

A young woman a short time since took these Pills for a violent pain in her 
side. After three doses she parted with a worm fourteen inches in length and 
one inch round ; she has since been perfectly well, and has kindly allowed Dr. 
B. to refer any one to her. 



It is a fact that there are good remedies, but it is very doubtful whether 
there are many good physicians. Extraordinary cures in which Brandreth's Pills 
have effected a perfect cure after the most eminent medical men had altogether 
failed : 

Mrs. Luther, of North Third Street, near Second Street, Williamsburg, for 
seventeen years was seriously afflicted with a violent pain in her left side, which 
often became very bad.' The side was wearing to all appearance away, and just 
over the seat of the pain was a place you might have laid an egg in. Extreme 
debility and general bad feelings were the consequence ; she could do nothing 
for herself and family with pleasure ; no relief was experienced from anything 
used until July last, when Brandreth's Universals were recommended, and im- 
mediate relief was experienced, and on the 31st of. December she assured Dr. 
B. the Pills had perfectly restored her health, and that her side was become like 
unto the other. Mrs. L. stated many other particulars, which, were there space, 
would be mentioned. 



CURES BY PURGATION. 203 

Cure of Terrible Ulceration. 

Second House from Tenth Avenue, Twenty-eighth Street, ) 

New York, Nov. 2, 1842. j 
Dear Sir : Last January I was taken suddenly with pain in my left side in 
the night, and my wife had to get up and steam it, but the pain got no better ; I 
then sent for Dr. Adams. He ordered a poultice of bread and yeast, and then a 
lump began to form about six inches from my arm-pit. Dr. Adams gave me pills 
which did me no good, and the pain still became more severe. At this period 
Dr. Adams brought another doctor with him, but I still continued to get worse, 
and although several other physicians came to see me, yet I continued to grow 
worse and worse. Dr. Adams opened at one time the abscess which first com- 
menced under my arm, and which had extended to my hip-bone and thence to 
the small of my back, and from thence to my shoulder-blades. Being poor, I 
sent for the dispensary doctors, and they attended me, but I continued to get 
worse, and the ulcers were some of them, such as I could see, more than half an 
inch deep. The doctors, both dispensary and the others who visited me, Only a 
few days before you called upon me, told me it was ten thousand to one whether 
I recovered or not — that I might not live through the night. This was in the 
early part of February. I had not been out of bed since the beginning of Jan- 
uary. At this time, the latter part of February, my wife went to see you, and 
beg you to come and see me. You dressed my ulcers for me that night — it 
took a yard of linen to dress them once. You left me two boxes of pills, which 
I used as you directed me, and my wife dressed me with your Universal Salve, 
and rubbed the callous places with the Liniment. In two months I walked to 
your office in Broadway, from Twenty-eighth Street, corner of Tenth Avenue. 
I came after that, seven or eight times for you, to see how my back got on, and 
to receive your further advice. I went on getting better every day, and my 
ulcers one after another got well, until the latter part of July, when I went to 
work, being a sound man, with the exception of having nearly lost the sight of 
my right eye, during my sickness, which, however, gradually gets better and 
better from the use of your pills. I send you this letter that you may publish 
it ; and should. any one wish to inquire any particulars of my extraordinary cure, 
they can see me where I live, which is the second house from the corner of 
Tenth Avenue, in Twenty-eighth Street. 

I remain, dear sir, 

Yours very respectfully, 

PATRICK BRALLEY. 
To Dr. Benj. Brandreth, 241 Broadway, New York. 



Edmeston, Otsego Co., Jan. 4, 1839. 
Dr. Brandreth : 

Dear Sir : I feel it a duty I owe to tne public, as well as yourself, to inform 
you of the astonishing efficacy of your truly valuable pills. I was attacked 
about the 1st of November last with the prevailing bilious or typhus fever, 
violently. The pain in my head and bad* was most excruciating. I took first 
six of your pills, then eight, ten and twelve at a dose twice a day, yet found 
no relief. My wife then . read your directions to me, after which I took 
seventeen, then twenty and twenty-two. I continued to take twenty morning 
and evening for four days, when I found the disease yielding and the fever liter- 
ally broken up; I then gradually diminished the quantities according to your 
directions. In two weeks I was out again.* I used no medicine but the pills. 

* Others who pursued the ordinary course were confined from six to twelve and fourteen 
weeks. 



204 CURES BY PURGATION. 

There has since been a number of cases of the same fever in my neighborhood, 
where the patients have followed the same course. J. E. used no medicine 
except your pills, according to your directions in " violent diseases," with the 
same happy effect. I took fifteen boxes ; another twelve, and others ten and 
down to four. Some used drafts upon the feet. 

Yours truly, 

WATERMAN BURLINGHAM. 



Melbourne, Victoria, 1st June, 1858. 
Mr. Blandford, Agent for Brandretli's Pills, Melbourne : 

Dear Sir : Having had a severe attack of inflammatory rheumatism, by 
which I was confined to my bed for several days, during which time I suffered 
the most agonizing pains in my side, back and limbs, and was fearful that I 
should be confined to my bed for a long time, my husband brought me one of 
Dr. Brandreth's pamphlets ; after reading it carefully, I concluded that I would 
try the pills, which I used as directed. I have been using them three weeks, and 
I am happy to say that to Dr. Brandreth's Pills I owe my recovery to health 
and strength. I feel stronger and better than I have done for a long time, and 
I am convinced that the disease is eradicated from my system. 
If you deem this letter of any use, please publish it. 
I am, dear sir, 

Very respectfully yours, 

MANDY WAYMAN. 
Little Bay Street, Sandidge. 

Melbourne, 1st Aug., 1858, 
Mr. J. T. Blandford : 

Dear Sir : I am a mason by trade, and for some time past have felt almost 
unable to attend to my business. Three weeks ago, on my way home 
in the evening, I stepped into a water hole and got quite wet, from the effect of 
which I took a severe cold, my whole body became much swollen, my breath- 
ing became very difficult. I had sharp pains in my chest, and in fact when I 
called on you at your office I considered myself in very great danger. I bought 
two boxes of Dr. Brandreth's Pills, and took six pills in the office and six more 
on my return home. In about five or six hours I discharged several quarts of 
water, and felt greatly relieved. I have continued to take the pills, and am 
happy to say am quite well. I consider the Brandreth Pills the means of sav- 
ing my life. I have heard them called the Poor Man's Medicine of America, 
where they are so celebrated. I trust they will be known as such here. I will 
never be without Brandreth's Pills as long as I can obtain them. 

Please publish this letter. I am anxious that the people here snould know 
where to get a medicine that they can rely on. 

I remain, dear sir, 

Yours respectfully, 

JOHN FLANNIGAN. 
Howard Street, North Melbourne. 



Park Street, South Yarra, Aug. 20th, 1858. 
Sir : This morning, having mislaid my spectacles when the morning's Age 
arrived, I took it up merely to endeavor to read the large type of the leading 
article, but judge my astonishment when I could, with facility, peruse the small- 
est type. This extraordinary fact I attribute to the use of Dr. Brandreth's 
Vegetable Universal Pills. Make any use you please of this communication. 

Yours very truly, 

JOHN HARRISON. 



CURES BY PURGATION. 205 

Letter of the Rev. Ezra Wilmarth, in favor of the Brandreth Pills. 

East Wilton, N. H., July 27, 1836. 
Dr. Brandreth : 

My Dear Sir : Having recently become acquainted with your valuable 
pills, and seen their salutary effects in a great variety of cases, I take the liberty 
of addressing you, stating my conviction of their value. Although I have 
heretofore been unfavorable to nostrums, I am fully convinced of the value of 
yours. 

I am a minister of the Gospel, of tne Baptist aenomination, in this town, and 
pastor of a church, and am well known ; therefore, I hope my recommendation 
of your Pills will be of some use in causing those who know me to make 
trial of them, as I feel confident they are calculated to promote the general 
health of mankind. 

Wishing you abundant success in your attempts to benefit the world, 
I am, with high respect, 

Your obedient servant, 

EZRA WILMARTH. 
I 



Bilious Remitting Fever and Dysentery Cured. 

Paterson (New Jersey), Aug. 18th, 1836. 
Sir : I write this out of respect to you for your excellent Pills, for both I 
and my family think it a great blessing that we have met with them again in 
this country, because we knew them to be excellent and good ; when at Leeds, 
in England, there it was always said if any person was sick, get a box of Bran- 
dreth's Pills and they will cure you. ■ 

Sir, I have been sick of a bilious and remitting fever, for which I got three 
boxes, and they have done me more good than all the physic ever I took in my 
life ; for before I took them I was almost gone with a liver complaint ; and now 
I am as well as ever 1 was in my life. In my family we have had three attacked 
with the dysentery; they (the Pills) cured them in two days, so that we have 
all of us great occasion to praise Dr. Brandreth's Pills. 
I am, sir, yours very truly, 

And greatly obliged, 

RICHARD HAMPSHIRE. 



Asthma Cured. 

Mr. John Benist, of No. 69 Chapel Street, New York, was afflicted with a 
dreadful asthma for nine years, during which time he was unable to lie down in 
bed, and frequently was gasping for breath, expecting every coming hour would 
be his last. He applied to several of the first physicians in New York, none 
of whom gave him the least relief. At last, Brandreth's Universals were 
strongly recommended, and in the course of a short time he found great benefit, 
and by continuing the Pills, he is now quite well, and able to attend to his 
business ; indeed he is perfectly restored to health. 



206 CURES BY PURGATION. 

Dyspepsia Cured. 

Newburgh, N. Y., Feb. 14, 1836. Dr. Brandreth— Sir : The many flatter- 
ing notices you ■ have received from respectable individuals, of the success of 
your Vegetable Universal Pills, render it unnecessary for me individually to 
eulogize, or those who are ignorant of the specific to censure. Having had 
ocular demonstration as well as bodily, J cannot refrain from expressing and 
publicly acknowledging the signal result and final cure of that dreadful disease 
known as Dyspepsia ; hoping such persons as may be afflicted with the above 
disease, this notice may influence some to make the experiment. You are at 
liberty to refer them to me voluntarily on my part. 
I remain your friend, 

JOHN A. STEVENS. 



Rheumatism. 

A gentleman who had lost the use of his limbs with Inflammatory Rheu- 
matism, and was so miserably afflicted that he could not turn in bed without 
assistance — the pains were violent in all parts of his body, but especially in 
his breast, back, arms and feet. This person took no other medicine than 
Brandreth's Pills — for two weeks he took 12 pills per day, and often as many 
as 20, and in three weeks he was able to get out ; and now, having persevered 
with them so as to produce copious evacuations every day, is at this time per- 
fectly cured ; it is not two months since he was first taken ill. Now, Dr. 
Brandreth would ask, would this have been the case with your bled man ? with 
the man to whom mercury has been administered 1 No ! he would have been 
in bed months, and his convalescence would have been tedious. The above 
gentleman is highly respectable, and can be referred to. 



A Running Ulcer of Three Years entirely removed with Eight Boxes of 

Brandreth's Pills. 

Edward Brown, son of Mr. James Brown, St. James Street, Kingston, 
Ulster County, for three years had a running ulcer in his hip, which obliged 
him to be carried about ; the doctors were in daily attendance, and the best 
advice was had from New York. All did not relieve the poor child, who was 
not expected to recover. Brandreth's Pills were commenced with* four months 
ago, and a decided change was effected before the third box was finished, and 
now, having taken eight boxes, 'is quite well. 

A little boy, aged four years, swallowed a pin, and, as a matter of course, 
his parents were much alarmed. His father called on Dr. Brandreth, who 
recommended him to give the child five or six pills per day, and no bad con- 
sequence would arise. This advice was taken, and on the fourth day powerful 
evacuations having been kept up, the pin was discharged, and not in the least 
corroded. Reference will be given to the parents, who are highly respectable. 

Mrs. S., in East Broadway, has been afflicted for nearly eight years with a 
bad leg, which prevented her going about. The sore was larger than the palm 
of the hand — she had had recourse to various doctors, who frequently healed it 
up, but in a few weeks was as bad as ever. Brandreth's Pills were recom- 
mended, and in a short time her leg was perfectly healed, and she is again able 
to walk with pleasure and comfort, and the leg has every appearance of being 
perfectly sound. Reference as to the above can be made to Mr. Aaron Swartz, 
grocer, corner of Pike Street and East Broadway. 



CURES BY PURGATION. 207 

Difficulty of Breathing Cured. 

Danbury, Conn., March 8, 1836. — Dr. Brandreth — Sir : Will you be good 
enough to send us some more of your Vegetable Universal Pills ? there are 
many persons here taking them for every complaint, and all find relief. . I can 
say they are the best medicine I ever took, and I have tried almost everything, 
but found no relief until I took your Pills. My difficulty of breathing is greatly 
relieved, and I am getting well. Many are taking them here for the same com- 
plaint, and find them very good. 

Yours, respectfully, ELIZA MORRIS. 



Piles Cured. 

Messrs. Coggershall & Walters, of New Bedford, have forwarded me the 
following facts of that most painful and unpleasant disease, the Piles. The 
original letter can be seen at 187 Hudson Street. Mr. MeFarlane, of New 
Bedford, has been laboring under that most dreadful disease, the Piles ; he has 
had them upwards of two years — has tried various things from different doc- 
tors, to no effect. Brandreth's Vegetable Universal Pills were had recourse to, 
and a complete cure is effected. He is now quite well. 



(Irom the Louisville inquirer.) 

Liver Complaint Cured. 

Newark, Dec. 25, 1836. 
Dr. B. Brandreth. 

Dear Sir : Having been afflicted for ten years with a most dreadful liver 
complaint and dropsy^ and tried every remedy that could be thought of, I gave 
up all hope, went into the country, left my business, to die in peace ; but hear- 
ing of your invaluable medicine, I was induced to try it, not expecting to be 
any better. To my surprise, I had scarcely taken one box before I felt relief. 
I have since taken three boxes, and now I am well, by the blessing of God and 
the use of your medicine. If you think this will be any service to let suffering 
people know this fact, you are at liberty to publish the above. 

Yours, with kind respect, 

(Signed,) LEWIS TOMPKINSON. 



Dysentery and Deafness Cured. 

August 20th, 1835. 
Sir : Allow me to express my grateful feelings for the benefit I have expe- 
rienced in your Vegetable Universal Pills in the cure of Deafness, which I have 
been subject to nearly thirty years. I have frequently been under eminent 
aurists in London, who have invariably syringed me, and who have all said no 
other mode of treatment would be of service. The latter part of May 1 again 
lost my hearing, with continual unpleasant noises in my head. It was with 
difficulty I could hear any one speak ; knowing you were an English surgeon, I 



208 CURES BY PUEGATION. 

applied to you to be syringed, thinking that was the only remedy ; yon refused 
to operate, but told me a box of your pills would have the desired effect, and I 
was induced to try them, especially when I found that many persons had been 
cured of the same complaint. I have taken two boxes, which cost me fifty 
cents, and am happy to say, am completely cured. The dose I took was two 
or three at night, and twice during the time I took five. They never incon- 
venienced me in the least, and were remarkably easy in their operation — I 
certainly can recommend them to any one laboring under the same unpleasant 
disease. 

Permit me likewise to say my "eldest daughter, two weeks since, had a 
dreadful Diarrhoea or Dysentery on her, which in two or three days reduced 
her frame, and I thought would have sent her to the grave. I immediately 
applied to you to know if the Vegetable Universal Pills would have the same 
beneficial effect on her as they had on myself; you told, me to persevere and 
they would make a cure — I had confidence in them, and am happy to say, by 
her taking from four to eight pills every night, the dreadful disease left in about 
a week. She is now well, and getting up her strength very fast. She took no 
other medicine whatever ; she continues occasionally one or two pills at night. 
My family had used the Hygeian Medicine for upwards of twelve months, and 
found they could not leave them off, as Costiveness and Piles were sure to fol- 
low. Thank God, your Pills leave no such enemies behind them. I have no 
hesitation in saying, that your Vegetable Universal Pills are the safest and best 
medicine myself or family ever took. Make what use you think proper of 
this communication, and you arc at liberty to refer any one to me, and I think 
I am only doing my duty in thanking you, through divine mercy, for the benefit 
received. 

I am, sir, yours very truly, 

JAMES LANCE, 
250 Eighteenth Street, near Broadway. 



Certificate of Joseph Goulden, who has known the above Pills forty years : 

/ hereby certify, that I have known Brandreth's Vegetable Universal Pills 

for upwards of forty years ; they were used in my family connections, in the 

County of Dorset, England, since the year 179G, many of whom they cured of 

old standing complaints. 

JOSEPH GOULDEN. 
Bridgeport, Feb. 18, 1836. ' 



Disease of the Prostate Gland Cured. 

Henry Lathrop, of Edmonston, Otsego County, New York State, a respect- 
able farmer, was afflicted for more than a year with this most painful, and gen- 
erally incurable disease. Some of our highest medical men pronounced his 
case incurable, and advised him to settle his affairs, and patiently await the 
result, as it was not in the power of medicine to save him. Mr. Lathrop, 
before he went home, called upon me, and having stated his symptoms, I told 
him what his disease was, and in this I agreed with the doctors who had said he 
was incurable. But I also told him I felt confident that if he would persevere 
with my Pills they would cure him. Mr. Lathrop proved his confidence by 
purchasing six dozen boxes, which he took home with him, and in about three 
months he returned to me in New York City a cured man, having used the Pills 



CURES BY PURGATION. 209 

as I directed. In fact, he said he never was better in his life. This was in 
1835. Since that period Mr. Lathrop has administered the pills to upward of 
a thousand persons, all of whom, he assures me, have derived the most aston- 
ishing benefit from their use. 



New Bedford, Nov. 7, 1835. 
Dr. Brandreth — 

Sir : About eight weeks past I saw some of your Pills, and read one of 
your wrapping-papers, but thought it was, as thousands of such things are now- 
a-days, a mere speculative, money-catching thing — still I was advised to try 
them by persons who said they were most righteous Pills. I was, however, 
faithless of their value ; but my complaint grew so violent that I purchased two 
boxes, took them according to the directions, and found that they helped me 
much. My neighbors, knowing how long I had been afflicted, were anxious to 
know the result, and I informed them that I had received great benefit from the 
two boxes, which would induce me to purchase more. My wife for a long time 
had been in a poor state of health. She also took some, and found great ben- 
efit. And now, sir,»excuse me while I detail some of my complaints, the main 
body of which seem as though the main springs of life were all fettered. 
DYSPEPSIA or INDIGESTION, Weakness of the Lungs, Nervousness, 
Rheumatism, SICK-HEADACHE, ASTHMA, GREAT LOSS OF APPE- 
TITE, LANGUOR, TREMOR, COSTIVENESS, etc., etc. Such have been 
my varied symptoms, but I must and will say, that I never took such medicine 
as your Pills, which seem to touch all parts of my complaints. I intend to 
persevere with them, and you may send me 500 boxes, which you must charge 
at the wholesale price. 

I am, sir, yours respectfully, 

SAMUEL S. ALBRO. 



Piles Cured. 

Messrs. Coggershall & Walters, of New Bedford, have forwarded me the 
following facts of that most painful and unpleasant disease, the Piles — the 
original letter can be seen at 187 Hudson Street. Mr. McFarlaue, of New Bed- 
ford, has been laboring under that most dreadful disease, the Piles. He has had. 
them upward of two years — has tried various things from different doctors to no 
effect. Brandreth's Vegetable Universal Pills were had recourse to, and a 
complete cure is effected — he is now quite well. 



Newburoh, N. Y., Nov. 4, 1835. 
Dr. Brandreth — 

Sir : I was induced some time since, by the persuasion of a friend, to try a 
box of your Pills. From the immediate relief and happy result I have re- 
ceived from the same, I cannot but recommend them to my friends, and par- 
ticularly to all invalids who may be afflicted with costiveness, not to despair 
until they have given your Vegetable Medicine a trial. 

Hoping you may be the means of making us poor creatures happy, and add 
to your popularity and wealth, I remain your friend, 

J. W. SWIFT. 
You may refer, or make what use you please of this letter. — J. W. S. 
14 



210 CURES BY PURGATION. 

Extraordinary Cure of Rheumatism, Diarrhoea, and Affection of the Lungs. 

John Shaw, of Pembroket, Washington County, Maine, being duly sworn, 
says that he was taken violently sick about six months since. The pains in his 
head, breast, back, left side, and instep bein^; so bad that he was unable to help 
himself, and was taken into the Chelsea Hospital in the City of Boston. That 
after being in said hospital five weeks, Dr. Otis said he did not know what was 
the matter with him, and that he could do nothing for him, nor could he prescribe 
any medicine. That he, therefore, was conveyed from the Chelsea Hospital to 
the Sailor's Retreat on Staten Island. That he was there physicked with all 
sorts of medicine for a period of four months, suffering all the time the most 
heart-rending misery. That, besides the affection of his bones, he was troubled 
much with a disease of the lungs. Sometimes he would spit a quart of phlegm in 
the day. Besides this affection he had a bad diarrhoea, which had more or less 
attended him from the commencement of his sickness. That at times he dreaded 
a stool worse than he would have dreaded death. That he can compare the 
feeling to nothing save that of knives passing through his bowels. After suffer- 
ing worse than death at the Sailor's Retreat on Staten Island, the doctor told 
him that medicine was of no use to him — that he must try to stir about. At 
this time he was suffering the greatest misery. That his bones were so tender 
he could not bear the least pressure upon the elbow or upon the knee ; that his 
instep was most painful; that, as the doctor said he would give him no 
more medicine, he determined to procure some of Dr. Brandreth's Pills, which 
he did from 241 Broadway, New York. That he commenced with five pills, 
and sometimes increased the dose to eight. The first week's use so much ben- 
efited him that the doctor, not knowing what he was using, said, " Now, Shaw, 
you are looking like a man again. If you improve in this way you will soon 
be well." That he found every dose of the Brandreth Pills relieved him ; first, 
they cured him of the pain when at stool ; that they next cured the diarrhoea, 
and finally the pain in his bones. That the medicine seemed to add strength 
to him every day. He told the doctor yesterday, the 11th inst., that he felt 
himself well, and also that he owed his recovery to Brandreth's Pills, under 
Providence — that he had taken the medicine every day for nineteen days. 
That the doctor told him if he had known he had been taking that medicine, 
he should not have stayed another day in the house. He considers it his duty 
to make this public statement for the benefit of all similarly afflicted, that they 
may know where to find a medicine that will cure them. 

JOHN SHAW. 

John Shaw, being by me duly sworn this 12th day of April, 1842, did 
depose and say, that the foregoing statement is true. 

JOHN D. WHEELER, 

Commissioner of Deeds. 



Cure of Insanity. 

Newark, March 8, 1838. 
Respected Sir : I have long felt it resting on my mind as a duty, to com- 
municate by way of letter to you, sir, the great benefit I have received from 
using your invaluable Pills ; they have proved a great blessing to my health. 
Eor the last two years I have had my health renewed by taking them after 
other physicians had failed in their efforts to relieve me of a disease that was 
fast tending to dropsy, and bordering on to madness of mind — insomuch I was 
pronounced insane by most all who saw me. As I was incapable of having 



CURES BY PURGATION. 211 

any charge of my family for nearly one year, a number of times I made an 
effort to take my life, but was prevented from so doing by that ever-watchful 
Eye that never slumbers nor sleeps. I am a living monument of the free 
mercy of the Lord to all who were witnesses of the disordered state that I was 
in when your medicine was thrown within my reach, and faith was given me to 
believe that it would relieve. I commenced taking it every night, and the first 
change I perceived about me was on the night after taking three doses. I felt 
a singular sensation in my ear, and on rubbing it, something gave way, that 
proved to be hard congealed wax. I felt such a relief of distress from my 
head, that I knew not what it could mean for some time, for the sound of my 
own voice appeared like another, and all sounds seemed different to my hear- 
ing from what they had for years past ; and for two weeks following the quan- 
tity of wax that came from out my ears would to many be pronounced too 
incredible to be relied on, unless they had seen for themselves, and my blood 
began to circulate more freely through my system, by gradually taking the 
pills which before had nearly ceased to move through my veins, and it appeared 
to me that my life was at times departing from the body. I could find nothing 
that animated or cheered my mind ; any way life had become a burden to me, 
but as my confidence strengthened in persevering with the pills, I found my life 
daily returning, and invigorating both body and mind, to the unspeakable joy 
of my family and friends ; and since they have proved such a blessing to me, I 
have felt it my duty to recommend them to all with whom I have intercourse. 
Standing myself as a witness of their virtue in producing health of body, which, 
beyond a shadow of doubt, will give clearness of mind and ideas, which can- 
not be clear if those organs where knowledge lies are obstructed by disease, 
which thousands of our fellow-creatures are suffering under, and are still made 
worse by the treatment of our most popular physicians of the present day, by 
taking blood, and giving many things that are daily undermining and ruining 
the constitution forever, from having that strength that is natural for us, if we 
pursue the right course to obtain it by simple remedies instead of those of 
another kind, which is so unnatural as bleeding. The argument you lay before 
the public, and the experience I have had for myself on this important subject 
wherein life is at stake, has thoroughly convinced me that bleeding is injurious, 
and can and ought to be dispensed with, as it has been ascertained to a certainty 
that other means have been discovered that have the desired effect in producing 
health without proving so pernicious to the constitution as those mentioned. 

I have been instrumental of convincing many to take them, but the most 
are bound by that strong cord of prejudice which will not so much as admit 
plain facts to be true, but endeavor to paint them in a different color from the 
original ones given ; but I am encouraged that the time is nigh at hand, that 
people are awaking from their slumbers, and seeking after truth in all things 
respecting this life, as well as the life to come. It is true that error abounds 
on all sides, but we know that truth is of divine origin, and will prevail in spite 
of all opposition that is thrown in its way by all who love not our Lord Jesus 
in sincerity of heart, and are making every effort to amass wealth by imposing 
on the public in various ways to deceive the unwary ; but let them beware and 
take heed to themselves, that the curse of the Lord is upon their riches if their 
eye is not single to His glory and the good of their fellow-men. It is love that 
has urged me to speak in so plain a manner to one who is an entire stranger to 
me, and I hope it may be received by you, sir, as coming from one whose mind 
has been freed from prejudice, knowing that the motive I have in view is the 
good of my fellow-beings, whose welfare I feel deeply concerned in. Although 
moving in a very humble and obscure sphere of life, to which many are placed, 
may the Lord greatly bless and strengthen your efforts in the cause that you 
are engaged in, is the prayer of my heart. 

You are at liberty to make use of these lines as you think best. 

MARGARET E. A. SIIATLAND. 
Dii. Bkandretii, New York. 



212 CURES BY PURGATION. 



St. Louis, November 28th, 1837. 

Gentlemen : I deem it a duty which I justly owe, not only to you, but to 
the whole community, to acknowledge the beneficial effects which have resulted 
to myself from the use of that highly serviceable medicine, Dr. Brandreth's 
Vegetable Universal Pills. 

About eight months since I was suddenly taken with the Dropsy in my feet, 
the surface of which was likewise covered with the Tetter. 

I had repeatedly taken the advice, and followed the prescriptions of several 
eminent physicians of St. Louis, but derived no benefit therefrom. 

I had also tried many experiments, and used every medicine that could be 
suggested, but without any visible abatement of the swelling, and they remained 
in this unnatural situation until my sufferings were alleviated by the aid of Dr. 
Brandreth's Pills. Shortly after 1 had commenced taking your medicine I dis- 
covered a visible alteration for the better ; the swelling gradually subsided, the 
Tetter entirely left, my bodily health daily improved, and my feet once more 
returned to their natural size. 

Two months have elapsed since my cure, and my feelings now warrant me 
in saying that through your instrumentality I have exchanged a painful disor- 
der for a good sound state of health. 

That suffering humanity may read, and benefit from this disclosure, 
I beg to subscribe myself, yours gratefully, 

MARGARET BROWN, 

St. Charles Street, St. Louis. 

To Messrs. Tousey & Michael, St. Louis^ Mo. 



Carrolton, Greene County, 111., Oct. 5, 1837. 

Gentlemen : I beg leave to inform you that my sister was taken about three 
weeks since with a violent intermittent fever ; at my request she took two of 
Dr. Brandreth's Pills, which did not affect her otherwise than by creating a 
faint sickness at the stomach. The next day she increased the dose, which 
operated powerfully. She took the third and fourth doses, after which she had 
no return of the fever, her strength increased rapidly, and her health has been 
good since. 

A sister of my wife had been in a decline for several months with strong 
symptoms of a confirmed consumption. She commenced taking Dr. Brand- 
reth's Pills, and before she had taken two small boxes in doses of three and 
four per day, a decided change for the better appeared. She still continues 
their use, and the glow of health is fast taking the place of her late consump- 
tive expression of countenance. She will persevere in their use from a positive 
conviction that her health will be perfectly re-established thereby. Other indi- 
vidual cases I could mention. Suffice it to say, that all who have used the Pills 
to my knowledge praise them. 

Very respectfully yours, 

M rp . n aj T . LUCIUS S. NORTON. 

Messrs. Tousey & Co., St. Louis. 



New Orleans, 14th Jan., 1838. 
" He that is wise is wise for himself, and he that scoffeth (at Dr. Brand- 
reth's Pills) alone must bear it." — Listen, oh, ye incredulous ! hearken unto 
the voice of your friend, and neglect not the counsels of those who have learned 
wisdom from experience. Know, you that are slow of heart to believe, that I 
am a man who has suffered many afflictions from a hereditary diseased system. 



CURES BY PURGATION. 213 

From my youth up I have never known 'what it was to enjoy a moment op 
health, till lately. My disease has been a chronic headache and a severe de- 
bilitating weakness and faintness at the pit of the stomach, which diseases have 
been in a great measure removed by taking only TWO BOXES of Dr. 
Brandreth's Pills. I can now say, and with truth too, that I know what health 
is by experience ; and I would that I could raise my voice so high that all the 
earth might hear. Then would I proclaim the virtues of this invaluable medi- 
cine. But what is my aim in all this ? Is it that I am interested in the sale of 
Dr. B.'s Pills 1 Most assuredly, no ; I am in no way connected with their 
rise or downfall ; but I recommend them for the benefit of mankind, and 
especially to those who are to receive the most benefit from their use, my fellow- 
citizens of the South. 

S. FRIEND. 



Grand Gulf, March 6, 1838. 
Mr. Joseph B. Brockway, 

Dear Sir : We wish you to send us some more of Dr. Brandreth's Pills, 
for we are entirely out. Since the people have found out we keep them they 
are called for every day. Send them by the first opportunity, and 

Oblige yours, &c, 

WHITEMAN & McFARREN. 



Mr. J. B. Brockway 



Warrenton, Miss., March 1, 1838: 



Agent for the sale of Brandrettts Pills. 
Dear Sir : Enclosed we hand you ten dollars, the amount of the bill with 
which you furnished us some time since. The pills we find very saleable, and 
the demand for them is very great ; in fact, so great is their reputed efficacy 
and virtue here, that we should feel ourselves in some degree guilty of crime, 
if we were to deprive them of so valuable a medicine. We wish you to send 
to us by some safe conveyance — by the captain or clerk of some boat in the 
trade — fifty dozen boxes Brandreth's Pills, and forward your bill "to us on the 
usual terms. 

Very respectfully, your obedient servants, 

JOS. TEMPLETON & CO. 



Port Gibson, Feb. 27, 1838. 
Mr. Joseph B. Brockway, 

Dear Sir : Enclosed you have ten dollars in payment for fifty boxes of 
Brandreth's Pills, left with me some time since by your agent. 

For some length of time after receiving the agency, there was but little 
demand for the article, as people were afraid of some deception ; but since it 
has become known, the demand for it is rapidly increasing. I am now nearly 
destitute of the article, and as I have daily calls for it, wish you would send me 
a supply by Mr. O'Neilly — 20 doz. boxes would not be too large a quantity. 

Respectfully yours, 

D. Y. THOMAS. 



Mrs. Elwell's Case. 

MRS EL WELL, then of Middlefield, Otsego Co., N. Y., was seriously 
attacked with inflammation of the stomach and bowels. She was given over 
by her physician, and a consultation of doctors was called. The decision was 
that she must di*. She, however, partially recovered, but her stomach was in 



214 CURES BY PURGATION. 

a very deranged state. Very little action could be produced on the bowels by 
the most skillful of the profession. She continued for many months under the 
treatment of one doctor after another, gradually growing worse, and so truly 
deplorable was her situation for four months before she tried the Brandreth 
Pills, that nothing passed her bowels except by the .aid of the most powerful 
cathartics. Sometimes eighteen of one kind of pills were.given to her, then say a 
dozen of another, and a portion of some other medicine, before action could be 
'produced, and then so great was her distress that, for the whole of the four 
months above alluded to, she invariably fainted when anything passed her 
bowels. In January, 1837, she thought she would try Brandreth' s Pills, and 
sent to my office in Cooperstown for a box. She took four pills. On going to 
bed, her husband enquired as to the effect of her new medicine. She replied, 
" that she did not feel any effect at all." lie then said, that in the morning, if 
she took a dozen more, he guessed they would operate like all the rest of her 
medicine. She answered, she did not know but it would, for she did not expect 
anything would cure her. However, early in the morning her bowels were 
moved, and without pain or distress, and consequently without fainting, to the 
utter astonishment of Mr. Elwell, and the great joy of his wife. In the course 
of a few hours, they operated four times equally easy, and the consequence was 
she did not lie down through the day more than one hour. She had not for 
months been able to sit up one hour in a day. The next evening she took 
another dose of four pills with the same happy effects. On the third evening 
Mr. Elwell called on me and purchased a large supply of the pills, related the 
above facts, and said he never would be without the pills in his house if they 
could be obtained. It is now two years since the above facts occurred, and 
Mr. Elwell informs me that his wife soon recovered her health, that he has 
never had occasion to call in a doctor for her since, and that her health is now 
very good. 

ELISHA FOOTE. 
Cooperstown, Feb. 22, 1839. 



Annual Report of Mr. Sinclair Tousey, General Brandrethian Agent. 

Louisville, October 18, 1837. 
Dr. Brandreth : 

Dear Sir : It is now one year since I opened an office in this city for the ex- 
clusive sale of your Vegetable Universal Pills, the sale of which since that period 
has increased beyond my most sanguine expectations ; I have been compelled 
to establish an additional office in the city of St. Louis, Missouri, for the more 
convenient supplying of that section of country. I was induced to become your 
agent here in consequence of being convinced of the unrivalled health-producing 
qualities of your pills. My aunt they effectually cured of what is commonly 
called a Sick Headache, of about thirteen days' standing, which had cften con- 
fined her to her bed for several weeks at a time. My mother they entirely 
cured of a violent pain in her side, with which she had been afflicted for several 
years ; myself they completely cured of habitual costiveness. These, together 
with numerous other cases that came under my observation while at New York, 
convinced me of their efficacy in every form and symptom of the only one 
disease, for I am a firm believer now in Brandrethianism. The pleasure I feel 
in making them known to my fellow-beings is more than I can well describe. 
1 presume, sir, that you are aware that your Pills were not known to any extent 
anywhere to the West of the Alleghany Mountains previous to my introducing 
them in Louisville ; taking this into consideration, together with the fact that I 



CURES BY PURGATION. 215 

am located in a fortress of M. D.'s (there is a medical college here) it makes 
my success and their unprecedented sale appear truly surprising. 

It affords me great pleasure to state that in every town where I have intro- 
duced these valuable pills that they have generally been received favorably, and 
their sale and popularity have invariably increased beyond all precedence, until 
scarcely any other medicine is used or thought of. 

The thousands of cures that have been effected by their use, together with 
thousands of testimonials received in their favor, have not only gone beyond 
my expectations, but they have perfectly astonished the bigoted enemies of the 
Brandrethian theory, and has, I am very happy to inform you, caused many, 
very many, who were formerly its bitterest enemies, to become its most zealous 
advocates. More than thirty-seven hundred of the most respectable of our 
citizens have voluntarily come forward and testified to the virtues of your medi- 
cine from their own experience. 

It now becomes my duty (which I think a pleasure), as your general agent for 
this section of country, to transmit you testimonials of a few of the very nu- 
merous cures effected by the use of your pills which have come under my own 
observation, and had I the liberty to use the name of every individual who has 
testified to their extraordinary virtues, it would not only astonish the Regulars, 
but it would cause the foundations of Esculapian practice to quake with fear, 
besides filling at least one large volume. This, however, is not at all necessary, 
as the fame of the medicine is now spreading with such unparalleled rapidity 
that ere long its happy influence will be universally appreciated throughout the 
civilized world, and the only question invalids will ask will be, " Where can I 
get Dr. Brandreth's Genuine Pills V 9 



Case I.— BILIOUS FEVER. 

Louisville, November 16, 1837. 
Mr. S. Tousey — Sir : I feel it a duty which I owe, not only to you but to the 
public generally, to acknowledge the great benefit which I have derived from 
the use of the Pills for which you are agent. I was attacked about six weeks 
since with chills and fever, from which I recovered in about three weeks, when 
I was almost immediately attacked with a bilious fever, from which I had great 
doubts of ever recovering. Fortunately, I was induced by some of my friends 
to give Brandreth's Pills a trial ; and I now find myself, after the free use of 
these Pills for a few days, perfectly restored in health and able to attend to my 
business as usual. After finding the happy effects of these Pills upon myself, 
I was induced to give them to one of my children — a girl eight years old — who 
had been ill for some time, apparently in a decline. It gives me pleasure to 
inform you that she is gradually getting better since we first used the Pills, and 
I hope in another week to apprise you of her complete recovery. 
I am, sir, very respectfully yours, 

FELIX WOOD. 



Case II.— DISEASE OF THE LUNGS. 

Mr. Summers, City Pump Maker, has been afflicted with the above com- 
plaint for seven years ; he tried a great many medicines before commencing 
with Brandreth's Vegetable Universal Pills, but never derived any benefit com- 
pared to what he received from them. He strongly recommended them to all 
as the best family medicine he ever used. Mr. Summers is well known in 
Louisville. 



216 CURES BY PURGATION. 

Case III.— FEVER AND AGUE. 

Mr. H. Humphrey was violently attacked with the Fever and Ague, and 
after using but four boxes of the Pills he found himself perfectly cured and able 
to attend to his business right off. Such is the extraordinary efficacy of your 
health-restoring medicine, which makes friends of, and creates health in, all who 
use it. Long life to its maker. N. B. — Mr. H. resides in Third Street. 



Case IV.— ERUPTION OF THE SKIN. 

Mr. James Conklin was afflicted with an eruption of the skin, together with 
severe pains in all parts of his body. He used several highly recommended 
medicines previous to trying our Pills, but all to no purpose ; he has used only 
a few boxes of them, and is now entirely free from all eruptions, his skin being 
now perfectly cured, and his body is quite healthy in every respect — no pains, 
appetite good, sleeps well. As many as fifty or sixty cases of eruptions of the 
skin have occurred where your Pills have been used and cures effected in this 
city. 

Case V.— GENERAL DEBILITY. 

Mr. John Downing's wife has been troubled wiun a general debility for a 
length of time ; she has tried a few boxes of Brandreth's Vegetable Universal 
Pills, and finds them of great benefit. She is encouraged to persevere with 
them, being convinced that they are the best medicine she ever tried — the 
opinion of all. 

Case VI.— DYSPEPSIA. 

Mr. James Allen, residing in Clark Co., Indiana, has been afflicted with 
Dyspepsia for several years ; he has tried but three 25-cent boxes and is much 
better, his appetite being restored, and his chest is free from pain with which 
he was troubled so much. His digestive organs are become healthy — that is all, 
but that is everything. 

Mr. Stockton, the writer of the following letter, 's well known in this quar- 
ter of the country. 

Case VII.— CHILLS AND FEVER 

Mr. S. Tousey : I am compelled by an impulse of gratitude to acknowledge, 
not only to you, but to the public generally, the beneficial effects produced upon 
my son by the free use of Dr. Brandreth's Vegetable Universal Pills, for which 
you are agent. About six months since, my son, 15 years of age, was very 
suddenly attacked by that vile disease called Chills and Fever. He was occa- 
sionally so violently stricken with it, that I. had given him up, and thought all 
medical aid was useless. I was prevailed upon by my friends and acquaint- 
ances to give Brandreth's Pills a trial, but it was a long time ere I was con- 
vinced of their efficacy ; I almost detested the idea, but my friends perse- 
veringly persuaded until I was compelled to yield, and I am happy to inform 
you that after the free use of these pills only thirteen days, he was thoroughly 
cured and restored to sound health, and I am now perfectly convinced that they 
are the best medicine extant. 

Very respectfully yours, 

E. F. STOCKTON. 

Louisville, 20th September, 1837. 



CURES BY PURGATION. 217 

Cask Vni'.— SWELLED LIMBS. 

Mr. H h has been afflicted for about 5 years with swelled limbs, accom- 
panied by very violent pains in every part of his body ; he was unable to 
attend to any business or obtain any rest by night. These symptoms were pro- 
duced by an excessive use of calomel. He used several bottles of Swain's 
Panacea and other remedies, but to little or no effect. He commenced with 
your Pills a short time since, and a few days ago he informed me the swellings 
had subsided, and the pain entirely left him. The Pills, to use his own words, 
^ made him feel like a new man." 

In addition to the above, I would state, I have known a great many other 
cases similar to the above, where Brandreth's Pills have been used with the 
same happy results, all of which go to prove the extraordinary power of your 
medicine in removing the most inveterate diseases from the system. 

Case IX.— LIVER COMPLAINT. 

Morgan County, Kentucky, Aug. 19, 1837. 
Mr. L. Tousey, 

Sir : It becomes my duty to acknowledge to you, and through you to the 
public, the great benefit my wife has derived from the use of Brandreth's Vege- 
table Universal Pills.- About three years since my wife was brought very low 
with an attack of the Liver Complaint. A physician was employed, and after 
prescribing some time to no effect, he gave us this consoling information, that 
he could do her no good, and he thought nothing else would. After continuing 
in this miserable state some months, I was induced, from an advertisement 
which I read in the Louisville Journal, to give her some of Brandreth's Pills, 
thinking they could do her no harm if they done her no good ; and it gives me 
pleasure to inform you that, contrary to our expectations (for we considered her 
beyond the reach of medicine), she began to recover, and is now quite well. 
Should you consider this of any service to you, you are at liberty to publish 
it. 

Respectfully yours^ &c., 

T. smith. 

Case X.— INFLAMMATORY RHEUMATISM, LOSS OF APPETITE, &c. 

Mr. James Johnson, residing in Grant County, Indiana, suffered for about 
three years with Inflammatory Rheumatism ; at times his feet were so much 
swollen that he could not get on his shoes ; besides this he was troubled with 
costiveness, being sometimes three or four days without a passage. In addition 
to this he had scarcely any appetite ; he had advice and medicine from several 
physicians, but without any benefit, except for a short time. He expected he 
never would again be blessed with good health. After reading numerous testi- 
monials in favor of Brandreth's Pills, and hearing them very highly recom- 
mended by some of his neighbors who had used them, he was persuaded to give 
them a trial, and now, after having used them about five weeks, he finds him- 
self able to put his shoes on and walk about as he used to do. Besides this his 
appetite is perfectly restored, his bowels also being regular and healthy. He 
says that he has an excellent appetite, and thinks Dr. B. should have a monu- 
ment erected to his memory for discovering so good a medicine. 

The following letter, from the Rev. M. W. Sellers, will no doubt be read 
with interest. Mr. Sellers is well known to numbers of our citizens here : 



218 CURES BY PURGATION. 

Case XL 

Mr. S. Tousey, 

Dear Sir : I send you the following account of my case, and hope it may 
be of service to you in prevailing upon other persons to give Dr. Brandreth's 
Pills a trial. In the fall of 1833 I was attacked with a severe pain in my 
breast, which continued to increase until a pain in my stomach and side took 
place, which brought me very low. I took different medicines to remove it, 
but to no effect. I then applied to Drs. Luster and Constant, of Louisville. 
They pronounced it a severe case of Dyspepsia and Liver Complaint. I com- 
menced using their medicines, and found great relief in my side and stomach. 
I was in hopes a cure was effected, but the pain in my breast still remained. 

They then tried external applications to great length, with no success ; and 
last winter the pain had become more violent. Mr. R. Barnett, of your city, 
informed me of Brandreth's Pills. I told him I had tried the Hygeian Pills 
without deriving any benefit ; he told me BRANDRETH'S PILLS were the 
best. I then applied to you, as you may recollect, for some of these pills. It 
appeared to me at the time that my strength was so fast declining that I could 
not live long without some relief. I commenced using the Pills, and shortly 
afterwards I was attacked with the pleurisy ; and as bleeding had become such 
a habit I was persuaded to be bled, but mended slowly, and at length I was 
more violently attacked with the same complaint again. It seemed to me that 
I could not live long. However, I took eight of Brandreth's Pills, and in the 
course of a few hours I felt better. I then took twelve more, and have had no 
pain in my side since. This encouraged me to continue their use for the pain 
in my breast, and I mended very fast. In one month I gained ten pounds in 
weight. I enjoy good health at present, and feel myself perfectly restored. I 
can say that Brandreth's Pills were the first medicine that appeared to relieve 
the pain in my breast, and in any case of sickness I would rather use these val- 
uable pills than any other medicine that I know of. By experience of said pills 
in my family, particularly in my own case, I know them to be good. My 
mother who lives with me, nearly seventy years of age, has been afflicted with 
a urinary complaint for about ten years, and by using these Pills during the last 
summer is now entirely well. I have known several cases of fever and ague, 
two or three cases of scarlet fever, and other diseases that the human family is 
daily subject to, cured by the use of these pills ; several of my neighbors are 
using them for the breast complaint, and all find relief. I have no doubt but 
a great many other cures would have been effected by perseverance with the 
pills, but there is one great difficulty they labor under — timid purchasers com- 
mence using them and take one or two small doses, just about enough to make 
them feel a little queer, and get frightened and then away to the doctor, who 
takes great care to cry down the pills, knowing it stands them in hand to do so. 

I reside in Lettersburgh, Clark County, Indiana ; I have been a resident of 
said county more than twenty years, eleven years of that time I have been a 
minister of the Gospel, of the Baptist denomination. I am aware of the great 
opposition these pills labor under ; but let me ask one question, viz. : What 
food is best suited to our nature and health ? I think the answer is, the vege- 
table. Then do not let us be opposed to the vegetable kingdom for our 
medicine. 

October 22, 1837. 



M. W. SELLERS. 



Annexed I send you extracts from letters received from my agents, whjeh 
make the proof in favor of your Vegetable Universal Pills almost over- 
whelming. 



CUBES BY PURGATION. 219 

The following extract is from the Postmaster at Henderson, Kentucky, 
dated 

Henderson, October 14, 1837. 
The fame of Brandreth's Pills is on the increase here, and I am daily 
receiving assurances of their efficacy in every complaint — fever and ague of a 
most aggravated nature has been in almost every case speedily and effectually 
cured. Yours, &c, &c, 

(Signed,) P. II. H. 

The following is from the Postmaster at Hutsonville, a small village in 
Illinois, dated August 16th, 1837 : 

As regards Brandreth's Pills, I believe they give universal satisfaction ; at 
all events, I cannot keep them on hand long — almost every person who has 
bought of them recommend them to their friends and continue themselves to 
use them — the last lot you sent me of fifteen dozen boxes did not last sales of 
two weeks. I have sold upwards of ten dollars' worth in one day, at retail. 

The above speaks volumes in their praise. Another agent writes : They are 
deservedly becoming so popular that I shall be able to vend a great quantity 
of them. I could furnish you a valuable receipt of their efficacy from expe- 
rience in my own family. Not only this, but the whole neighborhood bear 
testimony of their beneficial effects. 

In conclusion, I send you the annexed letter from H. Foster, Esq., my 
agent at New Albany, five miles below Louisville : 

New Albany, November 23d, 1839. 
Case XII. 

Mr. S. Touset : Your favor of 20th ult. was duly received as to the success 
of Dr. Brandreth's Pills ; I can state, in general terms, that I have sold about 
160 dozen boxes of these pills, and have made a great deal of inquiry of those 
that have used them, and find they have been very beneficial to this community. 
I can recommend them with the utmost confidence. I can here state that last 
fall, when I became an agent, my wife was in a very low state of health, and had 
a very distressing cough ; she was apparently on the eve of going into a con- 
sumption — the use of ten boxes of the pills entirely restored her, and she has 
never failed since that time, when indisposed, to receive benefit from a single 
dose. I am yours, &c, 

HUGH FOSTER. 

You will perceive by the above testimonials that your medicine is justly 
in high repute in this part of the country, as it must be everywhere where it 
is introduced. I could, as I stated above, had I time and space, extend the list 
of testimonials of its efficacy to several hundred pages. 

I would state that I have sold, during the year past, nearly eighty-five 
thousand boxes of your Vegetable Universal Pills, and have not the least doubt 
but I shall be able to dispose of more than double this quantity during the 
coming year, as those that have been sold have established a reputation for 
them that will last as long as the body of man is subject to indisposition. 

My office in Louisville is 99 Fourth Street, near Jefferson ; and in St. Louis 
at 56^ Market Street, near Third. 

Wishing you every success, I remain, sir, 

Respectfully yours, 

S. TOUSEY. 
To Dr. Benjamin Brandretu, New York. 



220 CURES BY PURGATION. 

Pleasantville, Mt. Pleasant, Westchester Co., June 10, 1859. 
Dr. B. Brandreth, 

My Dear Sir : I have long been a friend of yours, because I verily believe 
your valuable pills saved my life. I have recommended them for nearly twenty 
years, and don't want any others in my store. In 1849 I took a heavy cold, 
and being much exposed for some days afterwards, it settled on my lungs. 
For three months I was terribly troubled with a hacking cough and profuse-, 
night sweats, and reduced almost to a skeleton. • I took various syrups and cor- 
dials, but found no relief. At last a friend, Jesse Baker, of Miles' Square, 
Westchester Co., said, " Hammond, why don't you try Brandreth's Pills, they 
may help you." I bought a box, and took some. They purged me freely — my 
last dejection being a thick, viscid, yellow matter. I found myself greatly 
relieved at once, and within a week got entirely well. I recommend your pills 
to everybody, and they always do good. I shall always sell them, and I think 
they are the best medicine in the world for coughs, colds, consumption, and all 
kinds of sickness, for I know them by experience, having administered them to 
over one hundred cases of disease, and always cured. 

Yours truly, 

W. H. HAMMOND. 



Jaundice Cured. 

Mr. Benj. J. Stebbins, a highly respectable and well-known farmer of 
Pawlina, Dutchess County, N. Y., writes July 9th, 1859, that he was pros- 
trated with jaundice every spring and fall for years, in spite of all the efforts of 
physicians ; that he was cured by a few doses of Brandreth's Pills, and " has 
never suffered from the disease since." 



See page 21 for testimonial from Supervisor Bissell, of Newcomb, as to 
cures of small pox ; also, page 46, from sixty soldiers ; and page 151 as to 
cures of rheumatism. 

These testimonials are selected running through a period of nearly forty 
years, and to those who would learn have significance. 

B. BRANDRETH. 



INDEX OF DISEASES. 



PARAGRAPHS. 

Abscesses 28, 30, 140, 67, 97, 329 

Acute Disease 4, 20, 59, 191', 220 

Ague 577, 578 

Amenorrhea 576 

Anemia 658, 668 

Angina Pectoris 522 

Anorexia 344, 702 

Apoplexy 41, 143, 144, 181, 256, 278, 332, 

354, 484, 552, 691 

Asthma , 209 

Autumnal Disease 17, 112, 160, 221 

Blindness 41, 99 

Buboes 90, 109,240 

Bright's Disease Preface. 

Cseliac Passion 129. 135 

Cachexia „ 114,625 

Cancer 71, 614, 700 

Carbuncles 109 

Cardialgia 524 

Carus 144 

Catarrh 609 

Cerebral Diseases 514, 619, 702 

Chlorosis 307, 315,664, 680 

Cholera 162, 484, 568, 596 

Chorea 311, 321, 508, 549, 597 

Chronic Diseases 155, 159, 317, 485, 614 

Colic 65, 82, 138, 255, 418, 526, 428,618, 685 

Concussion of Brain 99 

Constipation 291, 292, 487, 527, 528, 570, 724 

Consumotion 323,370,382, 626, 627 

Convulsions 41, 428, 706 

Costiveness 246, 305, 307, 524 

Cramps 210, 217 

Croup 218 

Deafness ; . s 27 

Debility. .* . .169, 223, 234, 241, 246, 279, 303, 
323, 344, 409, 454, 585, 663 

Delirium 183, 452 

Diabetes 81, 362 

Diarrhea. . .2, 13, 69, 135, 142, 215, 252, 362, 

397, 435, 630, 599 

Dropsy 35, 38, 73, 211, 304, 362, 374, 603, 663 

Dysentery 38, 136, 198, 214, 221, 253, 285, 

352, 453, 541 

Dyspepsia 244, 507, 563, 131, 333, 555, 

668,731 

Enteritis 609 

Enterocele 83 

Epilepsy 150, 231, 306, 355, 440, 447, 486, 488 

Ervsipe'las 77, 474, 492, 667 

Eruptions of the Skin 247, 542 

Eruptive Fevers 274, 54:3 

Eve Disease 36, 80 



PARAGRAPHS. 

Fever. ... 30, 31, 37, 45, 51, 67, 87, 106, 114, 
152, 153, 159, 182, 190, 191, 194, 196, 
202, 203, 204, 208, 212, 245, 280, 282, 
301, 349, 362, 363, 368, 369, 370, 387, 
419,422,423,424, 452, 455,463,466, 
493, 518, 537, 538, 646, 547, 558, 565, 
630, 632, 638, 644, 656, 668, 678, 703, 
708, 718, 734. 

Fits , 350 

Flatulency .' 73, 82, 85 138, 151 

Fractures .100, 222, 228 

Foul Gases 701 

Gangrene 78 

Gastritis 370 

Gastrodynia 417 

Gout. , 40, 84, 85, 86, 158, 377, 378, 379,420, 
436, 439, 495, 522, 671, 692 to 697 

Gravedo 645 

Gravel 524 

Gripings , 21, 24, 599 

Headache 181, 605 

Head Disease 132, 442 

Heart Disease 464 

Hemiplegia 201, 332 

Hemorrhoides 71, 180 

Hepatic Complaint 216 

Hepatitis 653 

Hernia 230, 326, 343, 582, 651 

Hydrocephalus, . 225, 227, 232, 238, 353, 579 

706 

Hydrophobia 95, 313 

Hypertrophy 663 

Hypochondria 544 

Hysteria.,.., 310, 549,618 

Iliac Passion 137 

Indigestion 131, 333,555,731 

Infantile Diseases 226, 235, 428 

Inflammation. .. 72, 81, 89, 114, 141, 136, 218, 

482, 639, 653,655, 660, 715, 746, 751, 

664, 574, 641. 

Influenza 257, 258, 738 

Insensible Perspiration 102, 105, 706 

Insanity 567 

Intestinal Inflammation 482 

Jaundice 254, 535, 536, 668 

King's Evil 192 

Leprosy. 94 

Lethargy 144 

Lientery 38, 128, 135 

Liver Disease 568, 690 

Local Disease 331, 440 



222 



INDEX OF DISEASES. 



PARAGRAPHS. 

Lumbago 472, 645 

Malaria 668 

Malignant Diseases 383, 384, 385 

Malignant Fever. . . ; . .67, 106, 229, 399, 400 

Mania 41, 148, 448 

Marasmus 305, 315 

Measles 64, 92, 271, 379, 479 

Melancholy 147 

Menorrhagia 362 

Menstruation 33 

Mental Depression 575 

Mercurial Diseases 226, 242, 243 

Mesenteric Affection 141, 223 

Miasmata 281, 591 

Milk Fever. ,,,,,,., ,336, 606, 632 

Nausea 138, 240, 344 

Nephritis 370 

Nervous Diseases 120, 447, 459, 489 

Neuralgia 460, 490, 568 

Neurosis 448-548 

Obstruction 413 

Ophthalmia 36, 80, 239, 274 

Pains 22,52, 137, 138,184 

Pains in the Back 138, 141 

Palpitation 314, 464, 573 

Palsy 76, 151, 159, 181, 201, 497 

Paralysis 341 

Paraplegia 201 

Paraphrenias 146 

Pericarditis 744 

Peripneumonia 

Peritonitis 505 

Phthisis 18 

Phrenitis 146 

Piles 180, 633 

Plethora. % 15, 50, 104 

Pleurodynia 645 

Pleurisy 92, 166, 480, 521 

Paeumony 380, 381, 607, 638, 743, 753 



PARAGRAPHS. 

Prickly Heat 262 

Purpura 433 

Plague 96, 109, 240 

Puerperal Fever 208, 632, 644 

Rheumatism 370, 379,419,467-471, 509, "559- 

562, 568, 609, 635, 645, 674, 715, 716, 721 

Ringworm 91, 517 

Scarlet Fever 164, 277, 303, 416 

Sciatica 88, 472, 645 

Scrofula 498 

Scirrhus 73 

Small Pox 64, 92, 379, 431, 543, 748 

Spasmodic Diseases 217, 350, 366, 618 

Squinancy 92 

Sore Throat .72,475 

Strangury 89, 285 

Structural Diseases 

Syphilis 638,639, 668-9 

Sweats, 43, 105, 182, 190, 193, 195, 205, 206, 

■ 207, 398, 723 

Synocha 218, 237 

Tetanus 75, 312, 340, 365,367 

Toothache 523 

Torpor of Intestines 134, 345 

Torticollis 

Tumors 34, 67, 70, 634 

Tetters 91 517 

Typhus . ,218, 233, 297, 358, 428 430, 434, 454, 

300, 303 483, 520, 539, 540, 583, 

623, 647, 668. 

Ulcers 49, 79, 140, 329, 481, 687 

Vertigo 145 

Vitiated Blood 122 

Worms 93, 355, S56, 357, 532, 617 

Yellow Fever, 229, 249, 260, 261, 262, 263, 
264, 370, 385, 402 



INDEX OF AUTHORS QUOTED. 



PARAGRAPH. 

Abercrombie 563, 564 

Abernethy 315, 341 

Addison 749 

African Savage 383 

Ainsie 553 

Allen 

Alison 661 

Andral 550, 555, 556, 557, 592 

Annesly 565, 566 

Aretaeus 256 

Armstrong 430, 432 

Asclepiades 63 

Auld 245, 246 

Avicenna 65 

Badger 247, 248 

Bancroft 540 

Bardsley 257 

Barlow 410, 421 

Bartlett 688, 689 

Bayle 567 

Bache 209 

Beclard 592 

Bell, Benj 228 

Bell, John 228 

Bennet, J. Henry 743-746 

Bennet, J. H'ghs 747-757 

Bennion 282-284 

B. G. B 422, 423 

Bichat 592 

Blegborough ". 342 

Boyle 494 

Bradley 343 

Briggs 365-367 

Brown, John 568 

Bryce 408 

Buchan 417 

Budd 690 

Burserius 434 

Canstadt 657-664 

Carpenter 736 

Caristo 

Carson 226, 227 

Chambers 558 

Chapman, John N 228 

Chapman, N 495-497 

Cheyne 350-353 

Chomel 623 

Clark, Dr 397 

Clark, Thomas 285 

Clark, James 625, 626 

Clark, Joseph 428, 429 

Cleghorn 384 

Clendenning 706 

Collins 127-151 

Combe 628,629 



PARAGRAPH. 

Connoly 627 

Conradi 210 

Cooke 569-578 

Copeman 691 

Copland 586-621 

Cozzi 685 

Crampton 517 

Crichton 668, 669 

Cullen 202 

Currie 249, 251 

Denman 211 

Dick 724, 725 

Dickson, D. J. H 450,454 

Dickson, S. H 737-742 

Dropes 455-458 

Forbes 630-640 

Fowle 229 

Frank 538 

Franklin 385 

Friend 423 

Fricke 559 

Galen 79 

Gregory 218 

Gay ." 354 

Geoghegan 230 

Good 523-544 

Gully 670 

Halliday 355-358 

Hall 707, 708 

Hamilton, James 286, 319 

Hamilton, John 480, 481 

Harrison 709, 710 

Hartz.. 433, 434 

Harvey, William 121-126 

Harvey, Gideon 167-182 

Harvey, James 183-191 

Haspel 734, 735 

Haygarth 540 

Hazard 761-776 

Heberden 252-255 

Heller 740 

Henderson 212-217 

Hillary 397 

Hippocrates 1-62 

Hosack 518-522 

Houston 686 

Huenefeldt 665 

Huggan 218 

Humboldt 399 

Hunter 325 

Jones 671 

Johnson. Ed 727-732 



224 



INDEX OF AUTHORS QUOTED. 



PARAGRAPH. 

Johnson, Jas 482, 493 

Kennedy 652 

Kingslake 258, 259 

Kirkland 396 

Kramer 740 

Laennec 624 

Lane 

Lanza 672-673 

Lawrence 651 

Leeson 711, 712 

Lemazurein 467 

Liebig .727 

Lind 403 

Lloyd 498 

Louis, Ch. A 641, 642 

Louis, E. H 643 

Mackin 692-697 

Magendie 713, 714 

Markham. . „ 

Magennis 231 

Marx 622 

Martin 424,426 

Mcllwain 646 

McCullock 568 

McKenzie 581 

McLeod - 674 

Mead 543 

Meterius 87 

E. Miller 219, 220 

Mitchell 390 

Moore, I... 237 

McMullen 320-324 

Medicus, Pathology 435-446 

Medicus 277 

Miller 205-207 

Monat and Henderson 579, 580 

Moore, G 644 

Morgan, Chas 344-348 

Morgan, G. F 653-656 

Mosely 396 

Manneley 666, 667 

Mckoll 499 

Nooth 221 

O'Berne '. 260-279 

(Esterlein 740 

Parey 66-100 

Paris 545-552 

Parise 645 

Patterson 278 

Pearson. 279-281 

Pennington 391 

Philip 



PARAGRAPH. 

Pickford 758-760 

Pidduck 687 

Pott 228 

Potter 271-273 

Power 274, 275 

Pring 505-516 

Pringle 193-201 

Pricards 238 

Pritchard 447-449 

Redman 396 

Reeve 232 

Rhazes 64 

Richter 675-679 

Robertson 203, 204 

Rush 368-409 

Sanctorius ■ 101-120 

Sara 698, 699 

Savaresi 239 

Say ...396 

Schultz 680, 681 

Scudamore 559-562 

Selle 208 

Shaw 500, 504 

Sherwood 726 

Skimshire 222 

Stephens 582 

Stoker 583, 585 

Strack 434 

Sutton ..223,224 

Sydenham 152-166 

Taylor 700 

Tuomey 424-426 

Tainsh 240 

Tyro 256 

Unwins 323, 324 

Yage 241, 244 

Yandeswieter 256 

Yelpeau 592 

Vogel 701 

Waddley 276 

Waddy 702, 705 

Walsh 349 

Watt 359-364 

^egg ?33 

White 225 

Whydt 598 

Willan , 192 

Williams, C. J. B 682-684 

Williams, Robert 647-650 

Wilson, Andrew 459-479 

Wilson, J. A 715-723 

Woodward 235, 236 



